HomeMy WebLinkAbout063128-FP3 - Construction-Related - Contract - Trophy ConstructionCity Secretary
Contract No.
FQRT WQRTHo
Date Received
NOTICE OF PROJECT COMPLETION
(Developer Projects)
-FP3
63128
i�i2�zo26
AT
The Transportation and Public Works Department upon the recommendation of the Project
Manager has accepted the following project as complete:
Project Name: Longvue Baptist Church
City Project No.: 105310
Improvement Type(s): Water 0 Sewer 0
Original Contract Price:
Amount of Approved Change Order(s)
Revised Contract Amount:
Total Cost of Work Complete:
a� .��
Contractor
Project Manager
Title
Trophy Construction
Company Name
.��e a�
Project Inspector
?2awv 7"�v��
12am Iiwan (Jan 12 202610:13'.26 CS11
Project Manager
a�����
CFA Manager
��. %��
Lauren Prieur (Jan 12, 2026153037 CST)
TPW Director
$124,024.58
$1,685.38
$125,709.96
$125,709.96
O1/09/2026
Date
O1/09/2026
Date
0l/12/2026
Date
O1/12/2026
Date
O1/12/2026
Date
OFFICIAL RECORD
CITY SECRETARY
FT. WORTH, TX
Page 1 of 2
Notice of Project Completion
Project Name: Longvue Baptist Church
City Project No.: 105310
City's Attachments
Final Pay Estimate �
Change Order(s): � Yes ❑ N/A
Pipe Report: � Yes ❑ N/A
Contractor's Attachments
Affidavit of Bills Paid �
Consent of Surety �
Statement of Contract Time
Contract Time: 23 WD
Work Start Date: 10/22/2025
Completed number of Soil Lab Test: 28
Completed number of Water Test: 5
Days Charged: 36 WD
Work Complete Date: 12/19/2025
Page 2 of 2
FORTWORTH
CITY OF FORT WORTH
F1NAL PAYMENT REQUEST
Contract Name LONGVUE BAPTIST CHURCH
Contract Limits
Project Type WATER & SEWER
City Project Numbers 105310
DOE Number 5310
Estimate Number 1 Payment Number 1 For Period Ending 12/19/2025
WD
City Secretary Contract Number
Contract Date
Project Manager NA
Contractor TROPHY CONSTRUCTION SERVICES LLC
236 E. ELLISON STREET
BURLESON � TX 76028
Inspectors T. GARDNER / R. DAVIS
Contract Time �'�
Days Charged to Date �6
Contract is 100.00 Complete
Friday, December 26, 2025 Page 1 of 4
City Project Numbers 105310
Contract Name LONGVUE BAPTIST CHURCH
Contract Limits
Project Type WATER & SEWER
Project Funding
UNIT I: WATER IMPROVEMENTS
DOE Number 5310
Estimate Number 1
Payment Number 1
For Period Ending 12/19/2025
Item Description of Items Estimated Unit Unit Cost Estimated Completed Completed
No. Quanity Total Quanity Total
1 1 CONSTRUCTION STAKING 1 LS $478.89 $478.89 1 $478.89
2 4"-12" PRESSURE PLUG 1 EA $276.00 $276.00 1 $276.00
3 1 ASPHALT PVMT REPAIR BEYOND DEFINED 4.5 SY $2,970.66 $13,367.97 4.5 $13,367.97
WIDTH, RESIDENTIAL
4 TRENCH SAFETY 200 LF $112 $224.00 200 $224.00
5 DUCTILE IRON WATER FITTINGS W/ 0.2 TN $15,985.00 $3,197.00 0.2 $3,197.00
RESTRAINT
6 8" WATER PIPE 200 LF $39.66 $7,932.00 200 $7,932.00
7 FIRE HYDRANT 1 EA $7,839.00 $7,839.00 1 $7,839.00
8 CONNECTION TO EXISTING 4"-12" WATER 0 EA $4,288.00 $0.00 0 $0.00
MAIIV (CO#1)
9 1" WATER SERVICE (CO#1) 1 EA $2,667.50 $2,667.50 1 $2,667.50
10 8" GATE VALVE (CO#1) 0 EA $1,406.12 $0.00 0 $0.00
ll 2" WATER SEERVICE (CO#1) 1 EA $3,075.00 $3,075.00 1 $3,075.00
12 8"X8° TAPPING SLEEVE & VALVE 1 EA $6,972.00 $6,972.00 1 $6,972.00
Sub-Total of Previous Unit $46,029.36 $46,02936
UNIT II: SANTI'ARY SEWER IMPROVEMENTS
Item
No.
1
2
3
4
5
6
7
8
9
10
Description of Items Estimated Unit
Quanity
CONSTRUCTION STAKING 1 LS
TRENCH SAFETY 183 LF
TRENCH WATER STOPS 2 EA
4" SEWER PIPE 10 LF
8" SEWER PIPE 63 LF
6 8" SEWER PIPE, CSS BACKFILL 110 LF
3 LINER - 4' SEWER MH 32.2 VF
4' MANHOLE 2 EA
4' DROP MANHOLE 1 EA
EPTH MANHOLE 163 VF
Unit Cost Estimated Completed Completed
Total Quanity Total
$100.00 $100.00 1 $100.00
$1.50 $274.50 183 $274.50
$250.00 $500.00 2 $500.00
$50.80 $508.00 10 $508.00
$236.52 $14,900.76 63 $14,900.76
$200.00 $22,000.00 110 $22,000.00
$300.00 $9,660.00 32.2 $9,660.00
$9,643.00 $19,286.00 2 $19,286.00
$5,360.84 $5,360.84 1 $5,360.84
$435.00 $7,090.50 16.3 $7,090.50
Sub-Total of Previous Unit
$79,680.60 $79,680.60
Friday, December 26, 2025 Page 2 of 4
City Project Numbers 105310
Contract Name LONGVUE BAPTIST CHURCH
Contract Limits
Project Type WATER & SEWER
Project Funding
Contract Information Summary
Original Contract Amount
ChangC OY(leYS
Change Order Number 1
Total Contract Price
DOE Number 5310
Estimate Number 1
Payment Number 1
For Period Ending 12/19/2025
$124,024.58
$1,685.38
$125,709.96
Total Cost of Work Completed $125,709.96
Less % Retained $0.00
Net Earned $125,709.96
Earned This Period $125,709.96
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
$125,709.96
Friday, December 26, 2025 Page 3 of 4
City Project Numbers 105310
Contract Name LONGVUE BAPTIST CHURCH
Contract Limits
Project Type WATER & SEWER
Project Funding
Project Manager NA
InspeCtors T. GARDNER / R. DAVIS
ContraCtor TROPHY CONSTRUCTION SERVICES LLC
236 E. ELLISON STREET
BURLESON � TX 76028
DOE Number 5310
Estimate Number 1
Payment Number 1
For Period Ending 12/19/2025
City Secretary Contract Number
Contract Date
Contract Time 8 W�
Days Charged to Date 26 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
Less % Retained
Net Earned
Earned This Period $125,709.96
Retainage This Period �0.00
Less Liquidated Damages
o Days @ $0.00 / Day
LessPavement Deficiency
Less Penalty
Less Previous Payment
Plus Material on Hand Less 15%
Balance Due This Payment
$125, 709.96
$0.00
$125,709.96
$0.00
$0.00
$0.00
$0.00
$0.00
$125,709.96
Friday, December 26, 2025 Page 4 of 4
DEVELOPER-AWARDED-PROJECT CHANGE ORDER
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
Longvue Baptist Church
(A) WATER, (B) SEWER, (C) PAVING, (D) DRAINAGE, AND (E) STREET LIGHTS
CFA25-0016 I CITY PARTICIPATION:I
105310
63128
30114-0200431-105310-E07685
X-28088
K-3239
CHANGE
ORDER No:
NO
1
RANDELL DAVIS Phone No: 817-360-6317
RAM TIWARI Phone No: 817-392-2237
CONTRACT UNIT
WATER SEWER DRAINAGE PAVING STREET LIGHTS
Developer Developer Developer Developer
Cost City Cost Developer Cost City Cost Cost City Cost Cost City Cost Cost City Cost
$44,343.98 $0.00 $79,680.60 $0.00 $35,153.76 $0.00 $30,473.46 $0.00 $16,501.75 $0.00
So.00 go.00 $o.00 So.00 $o.00 So.00 $o.00 go.00 $o.00 go.00
So.00 go.00 $o.00 go.00 So.00 go.00 So.00 go.00 $o.00 go.00
$44,343.98 $0.00 $79,680.60 $0.00 $35,153.76 $0.00 $30,473.46 $0.00 $16,501.75 $0.00
$1,685.38 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00
Sae,029.36 go.00 $o.00 go.00 So.00 go.00 $o.00 go.00 So.00 go.00
$46,029.36 $79,680.60 $35,153.76 $30,473.46 $16, 501.75
Dev. Cost: $207,838.93 City Cost: $0.00
$207,838.93
WORKING
DAYS
23
23
0
23
REVIEWED
By TIWARIR at 3:08 pm, Nov 18, 2025
Revised: 12-17-2018 Page 1
You are directed to make the following changes in the contract documents
PAY ITEM #
8
9
10
11'
12*
CITY BID ITEM
# QUANTITY
3312.0117 1
33122003 1
3312.3003 1
3312.2203 1
3312.4005 1
�
Asterisk (*) indicates New Pay Item
UNIT
EA
EA
EA
EA
EA
UNIT I: WATER IMPROVEMENTS
ITEM DESCRIPTION
Connection to Existing 4"-12" Water Main
1" Water Service
8" Gate Valve
2„ Water Service
8"x8" Tapping Sleeve & Valve
CFW Unit
Price
TOTAL UNIT I: WATER IMPROVEMENTS
UNIT PRICE
-$4288.00
-$2667.50
-$1,406.12
$3075.00
$6,972.00
Developer
Cast
($4,288.00)
($2,667.50)
($1,406.12)
$3,075.00
$6,972.00
$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
$0.00
$0.00
1 685.38
City Cost
$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
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
0.00
�
TOTAL
($4,285.00)
($2,667.50)
($1,406.12)
$3,075.00
$6,972.00
$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
$0.00
$0.00
$1,685.38
�
.
REVIEWED
By TIWAR/R at 3:08 pm, Nov 18, 2025
Revised: 12-17-2018 Page 2
REASONS FOR CHANGE ORDER Upsrze of Water Service from 1' meter to a 2" meter, per developer's request Ghanges conespond to Revision Na. y as shown on sheet COS.Oo of the cnnsUuction
pfans Water Planning Bevelapment providetl approval for this cha�ge on 07/17J2024.
Field locate of Ex. 8" PVC WL(X-9055G) did not /ine up wrth whare ,'t was marked, unahle to inslaN cat-in-tee due to S7Sacing, Fieldilnspector stated he had no issue with
s�vitching to a Tapping S/eeve and Valve. ,
RECOMMENDED:
_ ...__._....____
8 _ _
-� Os�T�.:. � Z o_;
__.___ ___ _
��,�.�Q G��,��, �` r`f.(j __
Name:
Tilie: �� ��.; � /7A.c�-Dfd►1 0�— J /wU✓��
/
APPROVAL RECOMMENDED:
CFW - Water Depaament
aY= Not APpficabie
Name: Not Appiicable
T�tle: Not Appiicable
RECOMMENOED:
GFW - "Confract Comp/ianCe Man�ger
By-
Name:
Title:
Revised: 12-17-2018
APPRO VED: APPRO V ED: ;
(Developer} �ConUa tor)
.,
By�.�{. . I
��,.-� _: ' �� -- Ilaie l •-L1.L ! ='.- ,. � � I — ! � ,� � _ __
- -- n�}o .
_ �, _
� 5 �(�Y�
Name �I., ,�..� ,=�_. � c". Name:
r i
Title: ,�r _i fvr' ! �` G- 1'itle. �� �
APPRWED:
CFW - Assistant Cify Manager
�ate: Bu; NotAo�licable
Name: Not Applicabie
Title: Not Appiicabte
Date:
M&C Number. N(A
MB,C Daie Approved: N�q
ATTEST
APPR4VED AS TO FORM AND LEGAUIY:
CFW- Assistant City Attomey
Date: By Not Applicable Date:
s
i Name: Not Appllcable
Title: NotAppfi;able
By: Not Appiicabie Date:
Name: Jannerie S_ Goodall
Title: City Secretary
` Contract Compliance Manager (Projeci Manager):
By signing 1 acknowizdge that I am the person responsible
for the monitoring and aoministratio� of ihis contract,
and ensuring al! performance and reporting requiremen;s.
�There are NO City Funds associated with this Contract
❑There are City Funds associated with this Ccniract
� REVIEWED
By TIWAR/R at 3:08 pm, Nov 18, 2025
• -
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LEGEND
EXISTING
�a �ArER����E
oow ann ER � evice
iare we mereRawce
� FiaeHrorenNr
S�NEiPRV
5 INE
PROPOSED
�
�IRR
�
� s�R MTAN�o� �
warexwr, m
cnu i-wo-sa<-ean (rzras an) oa omEe
MLItt LOUiION SERNCES 48 HOURS VPIOP TO
CONSiRUL10N ACiNtt BAR� INN%ON FND
BROwN rvG 5 u0i RESPOµ58LE fOR KxpWNG
ALL ExSixC uiLrtES OR DEPCiNG ExaCT
�wAnoxs oN Au oxnwwcs.
GENEML Uilltt NOiE
nLL UTLiES uar NOi BE SNOWN ON ME �
UNS. LOCAiON Oi E%SiNG UiLiES -
UEPICiE� ON iHE PIANS ARE APPRO%IIAAiE R 0
SxALL BE iHE CONiRALi0R5 RESPoNSBLtt i0 Wpp109>]1
VERFY PLL IRlltt LOLAi0N5 PROR 10
CONSiRUC10N. ViL1E5 Dn�.wGED Bv ixE ��
COMRaCiOR DURiNG CONSiRUCiiON SxnLL BE
kEPNRED Ai iHE COMRAGi0R5 E%PENSE ������yox5
CONSTRUCTION NOTES
� o ( . ,i-azse
nu o e r i i� ;e�
�HORIZONTAL & VERTICAL CONTROL
iBM {/1 iBM //2
VAG NAL W�iH G nL N
' �HER N SPHAL ASPHAL
ELE✓ fiJJ JO ELEV fi5Z.9I'
N o9541 4 44 N 695400'8 24
E'22�3.+2018 E'�2J6212.Sv
Cltt PROJECi b105310 -���9
FID �_0114-0200631-IO»10-E0�6K5 �/+PS^0 N0. iAR-Ol2F
CITY OF FORT WOR'rH, TEXAS x
WATER, TRANSPORTATION AND �
PUBLIC WORKS DEPARTMENTS �
V
F
.�.
F
LONGVUE BAPTIST CHURCH y
07
•�-
AREA A - WATER PLAN �
DESIGNED � SCPLE 6ATE'. SHEET Q
oFqwry BHB I '-'o� I 04/28/2024 I('.05.D�fii '-�
FORTWORTH
TRANSPORTATION AND PUBLIC WORKS
PIPE REPORT FOR:
PROJECT NAME: Longvue Baptist Church
CITY PROJECT NUMBER: 105310
� WATER
PIPE LAID SIZE TYPE OF PIPE
8" PVC
FIRE HYDRANTS: 1
PIPE ABANDONED
SIZE
VALVES (16" OR LARGER)
TYPE OF PIPE
DENSITIES:
NEW SERVICES:
�
PIPE LAID
PIPE ABANDONED
DENSITIES:
NEW SERVICES:
1°(1)
f.y Y/I �I
SIZE
4"
g��
4"(1)
Copper
SEWER
TYPE OF PIPE
TYPE OF PIPE
PVC SDR 26
PVC SDR 26
PVC SDR 26
LF
200
LF
LF
LF
10
183
TRANSPORTATION AND PUBLIC WORKS
The City of Fort Worth • 1000 Throckmorton Street • Fort Worth, TX 76012-6311
(817) 392 - 7941 • Fax: (817) 392 - 7845
Fo������rx�
TRANSPORTATION AND PUBLIC WORKS
November 20, 2025
Trophy Construction Services
236 E. Ellison St.
Burleson Tx 76028
RE: Acceptance Letter
Project Name: Longvue Baptist Church
Project Type: Water/Sewer/Storm Drain
City Project No.: CPN 105310
To Whom It May Concern:
On December 23, 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 December 23,
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/ 2237.
Sincerely,
�u�r� 7"��
�, �_ � , ,,, �,
Ram Tiwari, Project Manager
Cc: Ariel Duarte, Inspector
Troy Gardner, Inspection Supervisor
Ariel Duarte, Senior Inspector
Andrew.Goodman, Program Manager
Baird, Hampton and Brown, Consultant
Trophy Construction Services, Contractor
Longvue Baptist Church, Developer
File
E-Mail: TPW_Acceptance@fortworthtexas.gov
Rev. 08/20/19
AFFIDAV IT
STATE OF Texas
COUNTY OF Johnson
Before me, the undersigned authority, a notaiy pubIic in lhe state
and county aforesaid, on this day personally appeared J. Wade AlIard,
Vice President Of Trophy Const��uction Services LLC, known to me to be
a credible person, rn�ho being by me duIy sworn, upan his oath deposed
and said;
Thai all persons, firtns, associations, corparations, or other
organizatzons furnishin� labor and/or materials have been paid in full;
That the wage scale esta6lished by the City Council in the City of
Fot� Worth has been paid in full;
That the�•e a�•e no claims pending for personal injuiy and/or
property damages;
On Conh�act described as;
Longv�e Bap�ist church Water• & Sewer Improvements CPN 105310
BY `�j!/� �
J. Wade Allard, VP
Subscribed and sworn befo�•e me on this date 9th of Januaiy, 2026,
� �/� � Yp GING�R FRANK�IN
�� I���� ' L�C/�' MY COA�EI4i11S510N EXPIRES
� y� �
*'��'* OCTOB�R 28, 2029
o a� r y 1'u c �, �,
'�oF� N�TARY ID: 129608646
�ohnson, T as
CONSENT OF ova�R o
SURET� COMPAN� .�cxr�r�cr o
TO FINAL PAYMENT cn��cToR ❑
SURETY C7
AIA DOCUMENT G707 OTHER
Bond No. 4484842
PROJECT: Longvue Sapfist Cb�urc� - Undergraund utilities (Water, Sa�aita�-y Sewer, Drainage}, City
(name, address) Project #105310, CFA25-0016, Fort Worth, TX
TO (Owner) [ The City of Fort Worth
and Longv�e Saptist Che�rch
�
ARCHITECT'S PROJECT NO:
CONTRACT FOR:
�
CONTRA.CT DATE:
j
CONTRACTOR: Trophy Construction Services LLC
308 E. Renfro $t. Ste. l0I
Burleson, TX 76028
In accordance with the provisions of the Contract beiween the Owner and the Contractor as indicated above, the
(here insert name and address of Surery Company)
S�reTec Insurauce Coznpany
2103 CetyWest Boutevard, Suite 1300
Houston, TX 7704z > SURETY COMPANY,
On bOnd of (here insert name and address of Contractor)
Trophy Constructian $ervices LLC
3U8 E. Renfro St. S#e. 101 , CONTRA.CTOR,
$urleson, TX 76028
hereby approves of the final payment to the Contractors, and agrees that final payrr�ent to the Contractor shall nat relieve
the Sure'ty Company of any of its obligations to {here insert name and address of Owner)
The City of Fort Worth and Longvue Baptist Church
,OWNER,
as set forth in the said S�zrety Company's bond.
IN WITNESS WfIEREOF,
the Surety Company has hereunto set its hand this 6th
�
Attes�: }� �':� � ��..��. �
(Seal):
day of Jan�ary
SureTec Ynsurance Compan�
Surety Company
�`✓'�'�.���f��'=..�-�_� .�..,8
Signaiure of Authorizad Repre�ntative
�..
Sandra Lee Roney
Title
2Q26
Attorne�-I�-Fact
NpTE: This form is to be used as a companion dacument to AIA T70CUN3E?�"1' G70b, CONTi�ACTOIt'S AFPTT7AVIT OF PAYMENT OP DEBTS AND CLAIMS,
Current Edition
ATA DOCUMENT G707 • CpAiSENT' OP Si7RPTY COMPAiJY TU FMFii, PAYM�N1' • APRTL 1970 EDiTION . AIAOO ONE PAGE
O 1970 + THE AMERICA,N INSTITUTE OF Al2C?I:'�'ECTS, 1735 I�ie:v ,'prk Ave, NW, WASHINGTON, ]�.C. 20006
POA# 422'f 992
�QINT LIMITED POWER 4F ATTORN�Y
lfNOW ALL MEN BYTHESf PRESEN7S: That SureTec lasurante Company, a Corporation dulyorganized and existing underthe laws of the State o�Texas and having its
prinCipai ofFue in the Coursty of Harris, Texas and Marlcei Insurance Company (the "Company"}, a corparation duly vrganized and existing under the laws pfthe state
of Ill�nois, and having its principal adm�nistrative office in Glen Alien, Virginia, does hythese presents make, constitvte and appoint:
�ebre l.ee Manrt, Santlra �ee Rcney, andrea Rose CrawFord, Troy Russell ICey, 7ohn R. Ward, Thomas DougEas Moore, Emily Al�ison Mikeska, Allyyon W Dean, Colln �. Conly, andrew Gareth Addison,
Elizabeth Ordz, Patrfck Thomas Coyle, Ana Owens, faith Ann Hilry, Christopher Chase Carllste, Frances Nartung, Stephan'�e Navarro, Brian P. Bordiee, Ross Laris, Gory Kiper, Kmherly Rorhelle
Gonzalez, Mark Rolser[ Adams, (}ysta! Gail I.anghom, 5teven Wayne Lewis, Haward Cawan, Alyssa .7. Lopez, Andrew Partri[k dark, Kellf A. Gorham, peggy GradeJ Fiogan,
Sheri Renee Allen, TEresa Ayala
Their ttue and lawful agent(s] and attorney(s)-in-fact, each in thsir separate capacity if more than one is named ahove, to make, execute, seal and deliver for and on
their own hehalf, individually as a surety or jointly, as ca-sureties, and as their act and deed any and all honds and other undertaking in suretyship provided, however,
that khe penal sum of any one such instrurrsent executed hereunder shall not exceed the sum of:
]n Unlimiterl Amounts
This Pawer of Attorney is granted and is signed and seaied u�der and by the autharity of the following Resolutions adopted by the Board of Directors of SureTec
lnsurance Corrspany and Market lnsurance Company:
"RESOLVED, That the President, any Senior Vice President, Vice Pres�dent, Assistant Vice President, Secretary, Assistant Setretary, Treasurer or Assistant Treasurer
and each of them hereby is authorized to execute powers at attorney, and such authority can be executed by use of facsimile signature, which may ba attested or
acknpwledged by any officer orattorney, of ihe company, qualifyingthe attamey orattorneys named in the given power of attorney,;o execute in behalfaf, and
acknowledge as Fhe aet and deed of the SureTec Insurance Company and Markel lnsurance Company, as the case may be, ail 6ond undeRakings and contracts of
svretyship, and to a{fix the corpprate seal thereto."
fN W 17NESS wHEREQF, h/earkel Insurance Corripany and SureTec Insurance Company have caused their afficiai seal to be t�erevnto a�xed and these presents to be
signe8bytheirdulyauthorizedofficersonthe zsu, dayaf �uiy , zo25 .
SureTec Insurance Cornpany S���CF
U�!r..�-.-.''.,. C'�
� � x `� • i �
w : tu b
-✓� � ; � � z'
gy; ��-,1 1 ls t-
Michael C_ Ke' ig, President ,�*�
State of 7exas
COunty of Harris:
`��a�iir�rr,,�
: ���'�yRA.lYg�i�'
�� : ro����'� =�'p'
:� =s ,r,as..: Y,z:
i����4r'*"q`�``�:
Markel�lr s��U�rance Corp�any
�� � �f
gY. , �' j � �( �
;'L�deyJennings,�Ylice President
V ll,i
�
On this �Bth day of duiy , 2025 A. p., $efore me, a Notary Pu61ic of the State of 7exas, in and for ihe County of Harris, duly commissioned and qualified,
came THE ABOVE pFFIC�RS OF THE GOMPANiES, to me personally known to be the individuais and officers dascribed in, who executed the preceding instrument, and
ihey acknowledged the exewtion pf same, and being 6y me duly sworn, disposed and said thai they are the officers of the sai8 companies aforesaid, and [hat the
saa#s affixed to the proceeding instrvment are the Corporate Seals of said Corr�panies, and the Said torporate Seals and their signatures as offiters were du[y aPfixed
and suhscribed to the said instrument bythe authority and direction of the said companies, and that Resolutions adopted by the Board of [7irectors of said Companies
referred to in the preceding instrument is now in force. `'''1l� ��+j �+J'�,
IN TESTiMONY wHEREOF, I have hereunto set my hand, and afifixed my Qf€i�i��S����ofhjarris, the day ar�d year first above written.
. �5�,�-. ��Y p �e .,4�,�';r
� � �� '� `,c�s.. � ay: ��.�j/�'
- � �, }`r. ; Chelsea Turner, Notary Public
`� iG" �
= �- 9T y'C �% My commission expires 7/5/2R2$
;, i � (}. `�. +?`j t
_ d y325�?°� , `� ;
We, the undersigned D�cers of Sure7ec Insurance Corrtpany and Markei ln�'�oRrfralf �� certify that the origina] POWER QF ATTORNEY of which the
foregoing is a full, true and correct copy is stiSl in full force and effecC and has nSr,lg�er�e�+r��� .,4"
y��rwyuasns
IN WIT[�ESS WHEREOF, we have hereunto set our hands, and affixed the Seals af said Companies, an the �t� day of January . 202fi ,
$ureiec insurance Company� ri�._,�----� Nlarkel insurance Company
�� 3 ��; f`� ��,/ ; � j� � .
s ,�� , � 1, � � 1 � �
xv. T� d � J � ,. ��� ��°.,� BY �.=� jr � � ? t ,
M. 8 ent'6eaty, Ass tantSecretary �ndrew Marquis, AssisCan �� aetary
.'/
any instrument [ssued in ezcess of the penaSTy staced above Is to.ariy vd�d and withvut any vaGdiry. 422'1992
For verification of the authoriry ofthis Power you may call (7i3}812-C3J0 on any husiness day 6etween 830 AM and 5:60 PM CST.
SureTec Insurance Company
- - - - -- -
IMPORTANT NOTICE
Statu�ory Complaint Notice/F�ling of Claims
To obtain information or make a�omplaint: You may call tf�e Surety's toll free ielephone number for information or
to mak� a cpmpiaint or file a claim at: I-866-73Z�Q099. You may also write to the Surety at:
SureTec Insurance Company
9500 Arboretum Blvd., Suite
400
Austin, -i-X 78759
Yo� may cflntact the Texas �ep�rtm�nt of Insurance to obtain informatian pn companies, coverage, rights pr
complaints at 1-80Q-ZS2- 3439. You may write the Texas bepartment of Insurance at:
PO Box 149104
Austin, TX 78714-
9104
Fax#:512-490-1007
Web: htto:l/www.tdi.state.tx.us
Email: GansurnerPrateCtion@tdi.texas.gav
PREMTUM OR CLAIMS DISPUTES: St�quld you have a dispute cancerning your premium or about a cfaim, you
shovld contaGt the Surety first. If the dispute is nat resol�ed, you may contact the Texas Department of
Tnsurance.
SIC TX Rider i'£}f Req�ired Notices rev 07_2022 Page 7 af 1