HomeMy WebLinkAbout064597 - Construction-Related - Contract - Peachtree Construction, Ltd.CSC No. 64597
FORTWORTH�
CONTRACT
FOR
THE CONSTRUCTION OF
2026 ASPHALT RESURFACING CONTRACT 3
City Project No. 106175
Mattie Parlcer Jesus "Jay" Chapa
Mayor City Manager
Lauren Prieur, P.E.
Director, Transportation and Public Worl<s Department
Pi•epai•ed for
The City of Fort Wol•th
TRANSPORTATION AND PUBLIC WORKS
2025
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OFFICIAL RECORD
CITY SECRETARY G
FT. WORTH, TX
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Cit of FortWorth
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Standard Construction Specification
Documents
Adopted September 20ll
00 00 00
STANDARD CONSTRUCTION SPECIFICATION DOCUMENTS
Page 1 of 6
SECTION 00 00 00
TABLE OF CONTENTS
Division 00 - General Conditions
00 OS 10 Mayor and Council Communication
00 OS 15 Addenda
00 11 13 Invitation to Bidders
00 21 13 Instructions to Bidders
00 35 13 Conflict of Interest Statement
00 41 00 Bid Form
00 42 43 Proposal Form Unit Price
00 43 13 Bid Bond
00 43 37 Vendor Compliance to State Law Nonresident Bidder
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00 45 12 Prequali�ication Statement
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00 45 26 Contractor Compliance with Workers' Compensation Law
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00 52 43 Agreement
00 61 13 Performance Bond
00 61 14 Payment Bond
00 61 19 Maintenance Bond
00 61 25 Certificate of Insurance
00 72 00 General Conditions
00 73 00 Supplementary Conditions
Division O1- General Requirements
� O1 11 00 Summary of Work
� O1 25 00 Substitution Procedures
� O1 31 19 Preconstruction Meeting
� O1 31 20 Project Meetings
� O1 32 16 Construction Schedule
� O1 32 33 Preconstruction Video
� O1 33 00 Submittals
� Ol 35 13 Special Project Procedures
� Ol 45 23 Testing and Inspection Services
� O1 50 00 Temporary Facilities and Controls
� O1 55 26 Street Use Permit and Modifications to Traffic Control
� O1 57 13 Storm Water Pollution Prevention Plan
� O1 58 13 Temporary Project Signage
� O1 60 00 Product Requirements
� O1 66 00 Product Storage and Handling Requirements
� O1 70 00 Mobilization and Remobilization
� Ol 71 23 Construction Staking and Survey
� Ol 74 23 Cleaning
� Ol 77 19 Closeout Requirements
� O1 78 23 Operation and Maintenance Data
� O1 78 39 Project Record Documents
Last Revised
07/O 1 /2011
07/O 1/2011
02/08/2024
06/13/2025
02/24/2020
09/30/2021
09/30/2021
09/30/2021
09/30/2021
nQii��
09/30/2021
ntiii��
07/O l /2011
n� in�i���
06/13/2025
12/08/2023
12/08/2023
12/08/2023
07/O 1 /2011
03/08/2024
03/08/2024
Last Revised
12/20/2012
07/O 1 /2011
08/ 17/2012
07/O 1 /2011
10/06/2023
07/O 1 /2011
12/20/2012
03/11/2022
03/09/2020
07/O 1 /2011
03/22/2021
07/O 1 /2011
07/O 1 /2011
03/09/2020
07/O 1 /2011
11 /22/2016
02/14/2018
07/O 1 /2011
03/22/2021
12/20/2012
07/O 1 /2011
CITY OF FORT WORTH 2O26 ASPHALT RESURFACING CONTRACT 3
STANDARD CONSTRUCTION SPECIFICATION DOCUMENTS CITY PROJECT NO. 106175
Revised .Tune 13, 2025
00 00 00
STANDARD CONSTRUCTION SPECIFICATION DOCUMENTS
Page 2 of 6
Technical Specifications which have been modified by the Engineer specifically for this
Project; hard copies are included in the ProjecNs Contract Documents
Division 32 - Exterior Improvements
32 11 23 Flexible Base Courses
32 13 20 Concrete Sidewalks, Driveways and Barrier Free Ramps
Division 34 - Transportation
� 34 71 13 � Traffic Control
99 99 00 ADDITIONAL SPECIFICATIONS
276 TxDOT Specification — Cement Treatment (Plant-Mixed)
Technical Specifications listed below are included for this Project by reference and can be
viewed/downloaded from the City's website at:
httq://fortworthtexas.�ov/tpw/contractors/
or
https://apps.fortworthtexas.gov/Proi ectResources/
Division 02 - Existin� Conditions
� 02 41 13 Selective Site Demolition
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� 02 41 15 Paving Removal
Division 03 - Concrete
� 03 30 00 Cast-In-Place Concrete
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Division 26 - Electrical
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Division 31 - Earthwork
� 31 00 00 Site Clearing
� 31 23 16 Unclassified Excavation
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� 31 25 00 Erosion and Sediment Control
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Division 32 - Exterior Improvements
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03/11 /2022
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06/13/2025
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CITY OF FORT WORTH 2O26 ASPHALT RESURFACING CONTRACT 3
STANDARD CONSTRUCTION SPECIFICATION DOCUMENTS CITY PROJECT NO. 106175
Revised .Tune 13, 2025
00 00 00
STANDARD CONSTRUCTION SPECIFICATION DOCUMENTS
Page 3 of 6
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Concrete Curb and Gutters and Valley Gutters
Pavement Markings
Curb Address Painting
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Topsoil Placement and Finishing of Roadway Right-of-ways
Sodding
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� 33 OS 13 Frame, Cover and Grade Rings
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� 33 OS 17 Concrete Collars
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CITY OF FORT WORTH 2O26 ASPHALT RESURFACING CONTRACT 3
STANDARD CONSTRUCTION SPECIFICATION DOCUMENTS CITY PROJECT NO. 106175
Revised .Tune 13, 2025
00 00 00
STANDARD CONSTRUCTION SPECIFICATION DOCUMENTS
Page 4 of 6
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CITY OF FORT WORTH 2O26 ASPHALT RESURFACING CONTRACT 3
STANDARD CONSTRUCTION SPECIFICATION DOCUMENTS CITY PROJECT NO. 106175
Revised .Tune 13, 2025
00 00 00
STANDARD CONSTRUCTION SPECIFICATION DOCUMENTS
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Appendix
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GC-4.02 Subsurface and Physical Conditions
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GN-0.0 General Notes
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GP-0.0 Project Location and Exhibit
GS-0.0 Standard Construction Details
END OF SECTION
Page 5 of 6
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CITY OF FORT WORTH 2O26 ASPHALT RESURFACING CONTRACT 3
STANDARD CONSTRUCTION SPECIFICATION DOCUMENTS CITY PROJECT NO. 106175
Revised .Tune 13, 2025
12/9/25, 4:54 PM
CITY COUNCIL AGENDA
Create New From This M&C
DATE: 12/9/2025 REFERENCE **M&C 25-
NO.: 1139
M&C Review
LOG NAME:
�ORT �r'�'ORTI I
-��
2026 ASPHALT
RESURFACING CONTRACT
3
CODE: C TYPE: CONSENT PUBLIC NO
HEARING:
SUBJECT: (CD 5) Authorize Execution of a Contract with Peachtree Construction, Ltd., in the Amount
of $2,998,544.50 for the 2026 Asphalt Resurfacing Contract 3 Project at Various
Locations
RECOMMENDATION:
It is recommended that the City Council authorize execution of a contract with Peachtree Construction,
Ltd., in the amount of $2,998,544.50 for the 2026 Asphalt Resurfacing Contract 3 project at various
locations (City Project No. 106175).
DISCUSSION:
In the Fiscal Year 2026 Pay-Go Contract Street Maintenance Program, various types of street
maintenance projects are grouped into specific contract packages. The recommended construction
contract outlined in this Mayor and Council Communication (M&C) will provide street rehabilitation on
approximately 11.34 lane miles for the street sections below, under the 2026 Asphalt Resurfacing
Contract 3 project (City Project No. 106175).
Street
Acapulco Road
Beckwood Drive
Bermejo Road
Castillo Road
Craig Court
Craig Street
Escalante Avenue
Friarford Road
Jason Court
Kell Drive
Kingsmill Terrace
Meadowcrest Drive
Patino Road
Patino Road
Portman Avenue
Tiki Trail
Tommy Street
From
To
Hitson Lane Escalante Avenue
Hitson Lane Patino Road
Hitson Lane Cooks Lane
Hitson Lane
North Cul-De-Sac
Hitson Lane
►�C�TC��1� � � 7�]'iiR�
Portman Avenue
North Cul-De-Sac
Hitson Lane
Friarford Road
Hitson Lane
Beckwood Drive
Acapulco Road
Friarford Road
Lisa Court
Kell Drive
Escalante Avenue
Craig Street
Patino Road
South Dead End
Kingsmill Terrace
Craig Street
Tiki Trail
Patino Road
Friarford Road
Craig Street
Castillo Road
Escalante Avenue
Craig Street
Craig Street
apps.cfwnet.org/council_packeUmc_review.asp?ID=34000&councildate=12/9/2025 1 /3
12/9/25, 4:54 PM
Street
Woodfield Road
From
Friarford Road
M&C Review
To
Patino Road
This project was advertised for bid on August 20 and 27, 2025, in the Fort Worth Star-Telegram. On
September 18, 2025, the following bids were received:
Bidders
Peachtree Construction,
Ltd.
Time of
Bid Amount
Completion
$2,998,544.50 180 Calendar Days
Advanced Paving Company $3,110,162.30
Texas Materials Group $3,182,633.80
Eurovia Atlantic Coast, LLC $3,326,803.60
In addition to the contract amount, $455,584.00 is required for project management, material testing
and inspection, and $149,927.00 is provided for project contingencies. Funding is budgeted in the
General Capital Projects Fund for the Transportation and Public Works Department for the purpose of
funding the 2026 Asphalt ResurFacing Contract 3 project.
Construction for this project is expected to start in January 2026 and be completed by July 2026.
This project is located in COUNCIL DISTRICT 5.
FISCAL INFORMATION/CERTIFICATION:
The Director of Finance certifies that funds are available in the current capital budget, as previously
appropriated, in the General Capital Projects Fund for the 2026 Asphalt Resurfacing Con 3 project to
support the approval of the above recommendation and award of the contract. Prior to any expenditure
being incurred, the Transportation and Public Works Department has the responsibility to validate the
availability of funds.
TO
Fund Department Account Project Program Activity Budget Reference # Amount
ID ID Year (Chartfield 2)
FROM
Fund Department Account Project
ID ID
Submitted for Citv Manaqer's Office by_
Originating Department Head:
Additional Information Contact:
ATTACHMENTS
Lauren Prieur (6035)
Monty Hall (8662)
FID Table 2026 ASPAHLT RESURFACING CONTRACT 3(5).xlsx (CFW Internal)
Form 1295.pdf (CFW Internal)
MC Map CPN106175 2026AsphaltResurfacina Contract 3.pdf (Public)
Project Budget Summary CPN 106175.pdf (CFW Internal)
Program Activity Budget Reference #
Year (Chartfield 2)
Jesica McEachern (5804)
Amount
apps.cfwnet.org/council_packeUmc_review.asp?ID=34000&councildate=12/9/2025 2/3
12/9/25, 4:54 PM
SAM Search Report Peachtree Construction.ndf (CFW Internal)
M&C Review
apps.cfwnet.org/council_packeUmc_review.asp?ID=34000&councildate=12/9/2025 3/3
00 11 13
1NVITATION TO BIDDERS
Page I of 3
SECTION 00 11 13
INVITATION TO BIDDERS
RECEIPT OF BIDS
Electronic bids for the construction of 2026 ASPHALT RESURFACING CONTRACT 3, City
project No. 106175 will be received by the City of Fort Worth via the Procurement Portal
https://fortworthtexas.bonfirehub.com/portal/?tab=openOnportunities, under the respective
Project unti12:00 P.M. CST, Thursday, September 18, 2025.
Bids will then be opened publicly and read aloud beginning at 2:00 PM CST in the City
Council Chambers.
Your submissions must be uploaded, finalized and submitted prior to the Project's posted due
date. The City strongly recommends allowing sufficient time to complete this process (ideally a
week prior to the deadline) to begin the uploading process and to finalize your submission.
Uploading large documents may take time, depending on the size of the file(s) and your Internet
connection speed. The Bonfire portal can be accessed using Microsoft Edge, Google Chrome, or
Mozilla Firefox. Javascript must be enabled. Browser cookies must be enabled.
Electronic submission is subject to electronic interface latency, which can result in transmission
delays. All bidders or proposers assume the risk of late transmission/ submission. The City shall
not be held liable if an interested bidder or proposer is unable to submit a complete bid/response
before the published deadline due to transmission delays or any other technical issues or
obstructions. The City strongly recommends allowing sufiicient time to complete the submission
process (ideally a week before the deadline) to begin the uploading process and to finalize your
submission to give adequate time in the event an issue arises.
All submissions must be submitted electronically prior to the close date and time under the
respective Project via the Procurement Portal:
https://fortworthtexas.bonfirehub. com/porta l/?tab—openOpportunities
Failure to submit all completed required information listed in the respective Solicitation will be
grounds for rejection of a bid as non-responsive. No late bids/proposals shall be accepted. Bids
delivered in any other manner than using the Bonfire Platform (Procurement Portal) will not be
accepted or considered.
If, upon being opened, a submission is unreadable to the degree that material conformance to the
requirements of the procurement specifications cannot be ascertained, such submission will be
rejected without liability to the City, unless such bidder provides clear and convincing evidence
(a) of the content of the submission as originally submitted and (b) that the unreadable condition
of the Electronic Bid was caused solely by error or malfunction of the Bonfire Platform
(Procurement Portal). Failure to scan a clear or readable copy of a bid into the system does not
constitute and shall not be considered an error or malfunction of the Bonfire Platform
(Procurement Portal). Bidders are encouraged to fully review each page of every document within
their submission prior to submitting to ensure all documents are clear, legible, and complete.
SUPPORT
For technical questions, visit Bonfire's help forum at https://vendorsupport.gobonfire.com/hc/en-
us
Contact the Bon�re support team at Support@GoBonfire.com or by calling 1-800-354-8010.
CITY OF FORT WORTH 2O26 ASPHALT RESURFACING CONTRACT 3
STANDARD CONSTRUCTION SPECIFICATION DOCUMENT City Project No. 106175
Revised 2/08/24
00 11 13
1NVITATION TO BIDDERS
Page 2 of 3
To get started with Bonfire, watch this five-minute training video:
Vcndor Rcgistration and Submission [VIDEO] — Bonfirc Vcndor Support (gobon�rc.com)
GENERAL DESCRIPTION OF WORK
The major work will consist of the (approximate) following:
65,672 SY 2" Asphalt Pavement, Superpave SP-D
65,672 SY 2" Surface Milling
26,450 SY 3" Asphalt Pavement, Superpave SP-D
26,450 SY 11" Pavement Pulverization
424 TN CemlimeTM
42 EA Barrier Free ADA Ramp
DOCUMENT EXAMINATION AND PROCUREMENTS
The Bidding and Contract Documents may be examined or obtained via the Procurement Portal
https://fortworthtexas.bonfirehub.com/nortal/?tab=openOpportunities, under the respective
Project. Contract Documents may be downloaded, viewed, and printed by interested contractors
and/or suppliers.
EXPRESSION OF INTEREST
To ensure potential bidders are kept up to date of any new information pertinent to this project, all
interested parties should indicate their intent to bid in the Procurement Portal by selecting "yes"
under the Intent to Bid section. All Addenda will be posted in the Procurement Portal
https://fortworthtcxas.bonfirchub.com/portal/?tab=opcnOpportunitics, under the respective
Project.
PREBID CONFERENCE — Web Conference
A prebid conference will be held as discussed in Section 00 21 13 - INSTRUCTIONS TO
BIDDERS at the following date, and time via a web conferencing application:
DATE: Tuesdav, September 2, 2025
TIME: 9.00 A.M.
Invitations with links to the web conferencing application will be distributed directly to those who
have submitted an Expression of Interest.
If a prebid conference is held, the presentation and any questions and answers provided at the
prebid conference will be issued as an Addendum to the ca11 for bids. If a prebid conference is not
being held, prospective bidders should direct all questions about the meaning and intent of the
Bidding Documents electronically through the Vendors discussions section under the respective
Project via the Procurement Portal. If necessary, Addenda will be issued pursuant to the
Instructions to Bidders.
CITY'S RIGHT TO ACCEPT OR REJECT BIDS
City reserves the right to waive irregularities and to accept or reject any or all bids.
AWARD
City will award a contract to the Bidder presenting the lowest price, qualifications and
competencies considered.
CITY OF FORT WORTH 2O26 ASPHALT RESURFACING CONTRACT 3
STANDARD CONSTRUCTION SPECIFICATION DOCUMENT City Project No. 106175
Revised 2/08/24
00 11 13
1NVITATION TO BIDDERS
Page 3 of 3
ADVERTISEMENT DATES
August 20, 2025
August 27, 2025
END OF SECTION
CITY OF FORT WORTH 2O26 ASPHALT RESURFACING CONTRACT 3
STANDARD CONSTRUCTION SPECIFICATION DOCUMENT City Project No. 106175
Revised 2/08/24
00 21 13
1NSTRUCTIONS TO BIDDERS
Page 1 of 9
SECTION 00 21 13
II�f.��:7�L�J111[�]►f.�C�1:31�J�7�l.i.y
1. Defined Terms
11. Capitalized terms used in these INSTRUCTIONS TO BIDDERS are defined in Section
00 72 00 - GENERAL CONDITIONS.
1.2. Certain additional terms used in these INSTRUCTIONS TO BIDDERS have the
meanings indicated below which are applicable to both the singular and plural thereof.
1.2.1. Bidder: Any person, firm, partnership, company, association, or corporation acting
directly through a duly authorized representative, submitting a bid for performing
the work contemplated under the Contract Documents.
1.2.2. Nonresident Bidder: Any person, firm, partnership, company, association, or
corporation acting directly through a duly authorized representative, submitting a
bid for performing the work contemplated under the Contract Documents whose
principal place of business is not in the State of Texas.
1.2.3. Successful Bidder: The lowest responsible and responsive Bidder to whom City
(on the basis of City's evaluation as hereinafter provided) makes an award.
2. Copies of Bidding Documents
21. Neither City nor Engineer shall assume any responsibility for errors ar
misinterpretations resulting from the Bidders use of incomplete sets of Bidding
Documents.
2.2. City and Engineer in making electronic Bidding Documents available do so only for the
purpose of obtaining Bids for the Work and do not authorize or confer a license or grant
for any other use.
3. Prequalification of Bidders (Prime Contractors and Subcontractors)
31. Bidders or their designated subcontractors are required to be prequalified for the work
types requiring prequalification as per Sections 00 45 11 BIDDERS
PREQUALIFICATIONS and 00 45 12 PREQUALIFICATION STATEMENT. Firms
seeking pre-qualification, must submit the documentation identified in Section 00 45 ll
on Section 00 45 13 PREQUALIFICATION APPLICATION at least seven (7)
calendar days prior to Bid opening for review and, if qualified, acceptance. The
subcontractors listed by a Bidder on 00 45 12 must be prequalified for the appropriate
work types. Subcontractors must follow the same timelines as Bidders for obtaining
prequalification review. Bidders or Subcontractors who are not prequalified at the time
bids are opened and reviewed may cause the bid to be rejected.
Prequalifcation requirement work types and documentation are available by accessing all
required files through the City's website at:
https://www.fortworthtexas. �ov/departments/tpw/development/cfw-departments-tpw-
contractors under Division 00 - General Conditions and as follows:
CITY OF FORT WORTH 2O26 ASPHALT RESURFACING CONTRACT 3
STANDARD CONSTRUCTION SPECIFICATION DOCUMENT CITY PROJECT NO. 106175
Revised/Updated June 13, 2025
00 21 13
1NSTRUCTIONS TO BIDDERS
Page 2 of 9
3.1.1. Paving — Requirements document located at:
https://app-us3.c-
builder.net/public/nublicLandin�.asnx?QS=4d00804b 133b408a85 a69323 548dda25
3.1.2. Roadway and Pedestrian Lighting — Requirements document located at:
https://anp-us3 . e-
builder.net/public/nublicLandin�.aspx?QS=e43c4239775f4b2583552c029c6a1ed2
3.1.3. Water and Sanitary Sewer — Requirements document located at:
https://app-us3.e-
buildcr.nct/public/publicLandin�.aspx?QS=4fc66ff8c36c4c029d542d4c55114e8d
3.2. Each Bidder, unless currently prequalified, must submit to City at least seven ('�
calendar days prior to Bid opening, the documentation identified in Section 00 45 11,
BIDDERS PREQUALIFICATIONS.
3.2.1. Submission of and/or questions related to prequali�cation should be addressed to
the City contact as provided in Paragraph 6.1.
3.3. The City reserves the right to require any pre-qualified contractor who is the apparent
low bidder for a project to submit such additional information as the City, in its sole
discretion may require, including but not limited to manpower and equipment records,
information about key personnel to be assigned to the project, and construction schedule
to assist the City in evaluating and assessing the ability of the apparent low bidder to
deliver a quality product and successfully complete projects for the amount bid within
the stipulated time frame. Based upon the City's assessment of the submitted
information, a recommendation regarding the award of a contract will be made to the
City Council. Failure to submit the additional information, if requested, may be grounds
for rejecting the apparent low bidder as non-responsive. Affected contractors will be
notified in writing of a recommendation to the City Council.
3.4. In addition to prequalification, additional requirements for qualification may be required
within various sections of the Contract Documents.
3.5. Special qualifications required for this project include the following: OMITTED
4. Examination of Bidding and Contract Documents, Other Related Data, and Site
4.1. Before submitting a Bid, each Bidder:
4.1.1. Shall examine and carefully study the Contract Documents and other related data
identi�ed in the Bidding Documents (including "technical data" referred to in
Paragraph 4.2. below). No information given by City or any representative of the
City other than that contained in the Contract Documents and officially
promulgated addenda thereto, shall be binding upon the Ciry.
4.1.2. Should visit the site to become familiar with and satisfy Bidder as to the general,
local and site conditions that may affect cost, progress, performance or furnishing
of the Work.
CITY OF FORT WORTH 2O26 ASPHALT RESURFACING CONTRACT 3
STANDARD CONSTRUCTION SPECIFICATION DOCUMENT CITY PROJECT NO. 106175
Revised/Updated June 13, 2025
00 21 13
1NSTRUCTIONS TO BIDDERS
Page 3 of 9
4.1.3. Shall consider federal, state and local Laws and Regulations that may affect cost,
progress, perfarmance or furnishing of the Work.
4.1.4. OMITTED.
4.1.5. Shall study all: (i) reports of explorations and tests of subsurface conditions at or
conriguous to the Site and all drawings of physical conditions relaring to exisring
surface or subsurface structures at the Site (except Underground Facilities) that
have been identiiied in the Contract Documents as containing reliable "technical
data" and (ii) reports and drawings of Hazardous Environmental Conditions, if any,
at the Site that have been identified in the Contract Documents as containing
reliable "technical data."
4.1.6. Is advised that the Contract Documents on file with the City shall constitute all of
the information which the City will furnish. All additional information and data
which the City will supply after promulgation of the formal Contract Documents
shall be issued in the form of written addenda and shall become part of the Contract
Documents just as though such addenda were actually written into the original
Contract Documents. No information given by the City other than that contained in
the Contract Documents and officially promulgated addenda thereto, shall be
binding upon the City.
4.1.7. Should perform independent research, investigations, tests, borings, and such other
means as may be necessary to gain a complete knowledge of the conditions which
will be encountered during the construction of the project. For projects with
restricted access, upon request, City may provide each Bidder access to the site to
conduct such examinations, investigations, explorations, tests and studies as each
Bidder deems necessary for submission of a Bid. Bidder must fill all holes and
clean up and restore the site to its former conditions upon completion of such
explorations, investigations, tests and studies.
4.1.8. Shall determine the difficulties of the Wark and all attending circumstances
affecting the cost of doing the Work, time required far its completion, and obtain all
information required to make a proposal. Bidders shall rely exclusively and solely
upon their own estimates, investigation, research, tests, explorations, and other data
which are necessary for full and complete information upon which the proposal is
to be based. It is understood that the submission of a proposal or bid is prima-facie
evidence that the Bidder has made the investigations, examinations and tests herein
required.
4.1.9. Shall promptly notify City of all conflicts, errors, ambiguities or discrepancies in or
between the Contract Documents and such other related documents. The Contractor
shall not take advantage of any gross error or omission in the Contract Documents,
and the City shall be permitted to make such corrections or interpretations as may
be deemed necessary for fulfillment of the intent of the Contract Documents.
4.1.10. Indicate their intent to bid by selecting "yes" in the Procurement Portal
under the Intent to Bid section. You must indicate your intent to bid to be able
to submit a bid to the City.
CITY OF FORT WORTH 2O26 ASPHALT RESURFACING CONTRACT 3
STANDARD CONSTRUCTION SPECIFICATION DOCUMENT CITY PROJECT NO. 106175
Revised/Updated June 13, 2025
00 21 13
1NSTRUCTIONS TO BIDDERS
Page 4 of 9
4.2. Reference is made to Section 00 73 00 — Supplementary Conditions for identification
of:
4.2.1. those reports of explorations and tests of subsurface conditions at or contiguous to
the site which have been utilized by City in preparation of the Contract Documents.
The logs of Soil Borings, if any, on the plans are for general information only.
Neither the City nor the Engineer guarantee that the data shown is representarive of
conditions which actually exist.
4.2.2. those drawings of physical conditions in or relating to existing surface and
subsurface structures (except Underground Facilities) which are at or contiguous to
the site that have been utilized by City in preparation of the Contract Documents.
4.2.3. copies of such reports and drawings will be made available by City to any Bidder
on request. Those reports and drawings may not be part of the Contract
Documents, but the "technical data" contained therein upon which Bidder is entitled
to rely as provided in Paragraph 4.02. of the General Conditions has been identified
and established in Paragraph SC 4.02 of the Supplementary Conditions. Bidder is
responsible for any interpretation or conclusion drawn from any "technical data" or
any other data, interpretations, opinions or information.
4.2.4. Standard insurance requirements, coverages and limits.
43. The submission of a Bid will constitute an incontrovertible representation by Bidder. (i)
that Bidder has complied with every requirement of this Paragraph 4, (ii) that without
exception the Bid is premised upon performing and furnishing the Work required by the
Contract Documents and applying the specific means, methods, techniques, sequences or
procedures of construction (if any) that may be shown or indicated or expressly required
by the Contract Documents, (iii) that Bidder has given City written notice of all
conflicts, errors, ambiguities and discrepancies in the Contract Documents and the
written resolutions thereof by City are acceptable to Bidder, and when said conflicts,
etc., have not been resolved through the interpretations by Ciry as described in
Paragraph 6., and (iv) that the Contract Documents are generally sufficient to indicate
and convey understanding of all terms and conditions for performing and furnishing the
Work.
4.4. The provisions of this Paragraph 4, inclusive, do not apply to Asbestos, Polychlorinated
biphenyls (PCBs), Petroleum, Hazardous Waste or Radioactive Material covered by
Paragraph 4.06. of the General Conditions, unless specifically identified in the Contract
Documents.
5. Availability of Lands for Work, Etc.
CITY OF FORT WORTH 2O26 ASPHALT RESURFACING CONTRACT 3
STANDARD CONSTRUCTION SPECIFICATION DOCUMENT CITY PROJECT NO. 106175
Revised/Updated June 13, 2025
00 21 13
1NSTRUCTIONS TO BIDDERS
Page 5 of 9
5.1. The lands upon which the Work is to be performed, rights-of-way and easements for
access thereto and other lands designated for use by Contractor in performing the Work
are identified in the Contract Documents. All additional lands and access thereto
required for temporary construction facilities, construction equipment or storage of
materials and equipment to be incorporated in the Work are to be obtained and paid for
by Contractar. Easements far permanent structures or permanent changes in existing
facilities are to be obtained and paid for by City unless otherwise provided in the
Contract Documents.
5.2. Outstanding right-of-way, easements, and/or permits to be acquired by the City are listed
in Paragraph SC 4.01 of the Supplementary Conditions. In the event the necessary right-
of-way, easements, and/or permits are not obtained, the City reserves the right to cancel
the award of contract at any time before the Bidder begins any construction work on the
project.
5.3. The Bidder shall be prepared to commence construction without all executed right-of-
way, easements, and/or permits, and shall submit a schedule to the City of how
construction will proceed in the other areas of the project that do not require permits
and/or easements.
6. Interpretations and Addenda
6.1. All questions about the meaning or intent of the Bidding Documents are to be directed to
City electrically through the Vendar Discussions section under the respective Project via
the Procurement Portal
https://fortworthtexas.bonfirehub.com/portal/?tab=openOpportunities on or before 2
p.m., the Monday, ten days prior to the Bid opening. Questions received after this day
may not be responded to. Interpretations or clarifications considered necessary by Ciry
in response to such questions will be issued by Addenda. Only questions answered by
formal written Addenda will be binding. Oral and other interpretations or clarifications
will be without legal effect.
6.2. Addenda may also be issued to modify the Bidding Documents as deemed advisable by
ciry.
6.3. Addenda or clarifications shall be posted under the respective Project via the
Procurement Portal
https://fortworthtexas.bonfirehub. com/portal/?tab=openOpportunities
6.4. A prebid conference may be held at the time and place indicated in the Advertisement
or INVITATION TO BIDDERS. Rcpresentatives of City will be present to discuss the
Project. Biddcrs are encouraged to attend and participate in the conference. City will
transmit to all prospective Bidders of record such Addenda as City considers necessary
in response to questions arising at the conference. Oral statements may not be relied
upon and will not be binding or legally effective.
7. Bid Security
CITY OF FORT WORTH 2O26 ASPHALT RESURFACING CONTRACT 3
STANDARD CONSTRUCTION SPECIFICATION DOCUMENT CITY PROJECT NO. 106175
Revised/Updated June 13, 2025
00 21 13
1NSTRUCTIONS TO BIDDERS
Page 6 of 9
7.1. Each Bid must be accompanied by a Bid Bond made payable to City in an amount of
five (5) percent of Bidder's maximum Bid price, on the form attached or equivalent
issued by a surety meeting the requirements of Paragraph 5.01 of the General
Conditions.
7.2. The Bid Bonds provided by a Bidder will be retained until the conditions of the Notice
of Award have been sarisfied. If the Successful Bidder fails to execute and return the
Contract Documents within 14 days after the Notice of Award conveying same, City
may consider Bidder to be in default, rescind the Notice of Award and act on the Bid
Bond. Such action shall be City's exclusive remedy in the event Bidder is deemed to
have defaulted.
8. Contract Times
The number of days within which, or the dates by which, Milestones are to be achieved in
accordance with the General Requirements and the Work is to be completed and ready for
Final Acceptance is set forth in the Agreement or incorporated therein by reference to the
attached Bid Form.
9. Liquidated Damages
Provisions for liquidated damages are set forth in the Agreement.
10. Substitute and "Or-Equal" Items
The Contract, if awarded, will be on the basis of materials and equipment described in the
Bidding Documents without consideration of possible substitute or "or-equal" items.
Whenever it is indicated or specified in the Bidding Documents that a"substitute" or "or-
equal" item of material or equipment may be furnished or used by Contractor if acceptable to
City, application for such acceptance will not be considered by City until after the Effective
Date of the Agreement. The procedure for submission of any such application by Contractor
and consideration by City is set forth in Paragraphs 6.OSA., 6.OSB. and 6.OSC. of the General
Conditions and is supplemented in Section O1 25 00 of the General Requirements.
11. Subcontractors, Suppliers and Others
i i.�. L'� �,.,.,,,-a.,,,,.o ,.;�� �i,o r:�..�� u„�:�o�� �,,,,;�., n..a:�„r,.o rT„ � c i�c i n �n� i�t,e r;�..
��L� t?� �arb.,.:,.,,.:,,� „�,�.;�,...:.., L.,,�:ro�� ,.ra/,....: .�,��5 �171rr�OZ
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.�.�. �.�.; �� nn n c n n�,- ��.,.
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1.++..�.//�,.,lol;l„-,,,-...:1177��1.,.,.v.,/,.,.,ao�/f+,.,,,,-rl,/1„ro�r/4'r..,,.,-�L. ��,/!1 n n 77Cn2
11.2. No Contractor shall be required to employ any Subcontractor, Supplier, other person
or organization against whom Contractor or City has reasonable objection.
12. Bid Form
12. L The Bid Form is included with the Bidding Documents.
CITY OF FORT WORTH 2O26 ASPHALT RESURFACING CONTRACT 3
STANDARD CONSTRUCTION SPECIFICATION DOCUMENT CITY PROJECT NO. 106175
Revised/Updated June 13, 2025
00 21 13
1NSTRUCTIONS TO BIDDERS
Page 7 of 9
12.2. All blanks on the Bid Form must be completed and the Bid Form signed
electronically or signed in ink and scan. A Bid price shall be indicated for each Bid
item, alternative, and unit price item listed therein. In the case of optional
altematives, the words "No Bid," "No Change," or "Not Applicable" may be entered.
Bidder shall state the prices for which the Bidder proposes to do the wark
contemplated or furnish materials required.
12.3. Bids by corporations shall be executed in the corporate name by the president or a
vice-president or other corporate officer accompanied by evidence of authority to
sign. The corporate seal shall be affixed. The corporate address and state of
incorporation shall be shown below the signature.
12.4. Bids by partnerships shall be executed in the partnership name and signed by a
partner, whose title must appear under the signature accompanied by evidence of
authority to sign. The official address of the partnership shall be shown below the
signature.
12.5. Bids by limited liability companies shall be executed in the name of the firm by a
member and accompanied by evidence of authority to sign. The state of formation of
the firm and the official address of the firm shall be shown.
12.6.
12.7.
12.8.
12.9.
Bids by individuals shall show the Bidder's name and official address.
Bids by joint ventures shall be executed by each joint venture in the manner indicated
on the Bid Form. The official address of the joint venture shall be shown.
All names shall be typed or printed in ink below the signature.
The Bid shall contain an acknowledgement of receipt of all Addenda, the numbers of
which shall be filled in on the Bid Form.
12.10. Postal and e-mail addresses and telephone number for communications regarding the
Bid shall be shown.
12.11. Evidence of authority to conduct business as a Nonresident Bidder in the state of
Texas shall be provided in accordance with Section 00 43 37 — Vendor Compliance
to State Law Non Resident Bidder.
13. Submission of Bids
Bids shall be submitted electronically in the Procurement Portal on the prescribed Bid Form,
provided with the Bidding Documents, prior to the time indicated in the Advertisement or
1NVITATION TO BIDDERS.
14. Withdrawal of Bids
14.1. Bids submitted electronically may be withdrawn prior to the time set for bid opening
via the Procurement Portal
https://fortworthtexas.bon�rehub. com/portal/?tab=openOpportunities.
CITY OF FORT WORTH 2O26 ASPHALT RESURFACING CONTRACT 3
STANDARD CONSTRUCTION SPECIFICATION DOCUMENT CITY PROJECT NO. 106175
Revised/Updated June 13, 2025
00 21 13
1NSTRUCTIONS TO BIDDERS
Page 8 of 9
15. Opening of Bids
Bids will be opened and read aloud publicly. An abstract of the amounts of the base Bids and
major alternates (if any) will be made available to Bidders after the opening of Bids.
16. Bids to Remain Subject to Acceptance
All Bids will remain subject to acceptance for a minimum of 90 days or the time period
specified for Notice of Award and execution and delivery of a complete Agreement by
Successful Bidder. City may, at City's sole discretion, release any Bid and nullify the Bid
security prior to that date.
17. Evaluation of Bids and Award of Contract
17.1. City reserves the right to reject any or all Bids, including without limitation the rights
to reject any or all nonconforming, nonresponsive, unbalanced or conditional Bids
and to reject the Bid of any Bidder if City believes that it would not be in the best
interest of the Project to make an award to that Bidder. City reserves the right to
waive informalities not involving price, contract time or changes in the Work and
award a contract to such Bidder. Discrepancies between the multiplication of units of
Work and unit prices will be resolved in favor of the unit prices. Discrepancies
between the indicated sum of any column of figures and the correct sum thereof will
be resolved in favor of the correct sum. Discrepancies between words and figures
will be resolved in favor of the words.
17.1.1. Any or all bids will be rejected if City has reason to believe that collusion exists
among the Bidders, Bidder is an interested party to any litigation against Ciry,
City or Bidder may have a claim against the other or be engaged in litigation,
Bidder is in arrears on any existing contract or has defaulted on a previous
contract, Bidder has performed a prior contract in an unsatisfactory manner, or
Bidder has uncompleted work which in the judgment of the City will prevent or
hinder the prompt completion of additional work if awarded.
17.2. In addition to Bidder's relevant prequalification requirements, City may consider the
qualifications and eXperience of Subcontractors, Suppliers, and other persons and
organizations proposed for those portions of the Work where the identity of such
Subcontractors, Suppliers, and other persons and organizations must be submitted as
provided in the Contract Documents or upon the request of the City. City also may
consider the operating costs, maintenance requirements, performance data and
guarantees of major items of materials and equipment proposed for incorporation in
the Work when such data is required to be submitted prior to the Notice of Award.
17.3. City may conduct such investigations as City deems necessary to assist in the
evaluation of any Bid and to establish the responsibiliry, qualifications, and financial
ability of Bidders, proposed Subcontractors, Suppliers and other persons and
organizations to perform and furnish the Work in accordance with the Contract
Documents to City's satisfaction within the prescribed time.
17.4. Contractor sha11 perform with his own organization, work of a value not less than
35% of the value embraced on the Contract, unless otherwise approved by the City.
CITY OF FORT WORTH 2O26 ASPHALT RESURFACING CONTRACT 3
STANDARD CONSTRUCTION SPECIFICATION DOCUMENT CITY PROJECT NO. 106175
Revised/Updated June 13, 2025
00 21 13
1NSTRUCTIONS TO BIDDERS
Page 9 of 9
17.5. If the Contract is to be awarded, it wi11 be awarded to lowest responsible and
responsive Bidder whose evaluation by City indicates that the award will be in the
best interests of the City.
17.6. Pursuant to Texas Government Code Chapter 2252.001, the City will not award
contract to a Nonresident Bidder unless the Nonresident Bidder's bid is lower than
the lowest bid submitted by a responsible Texas Bidder by the same amount that a
Texas resident bidder would be required to underbid a Nonresident Bidder to obtain a
comparable contract in the state in which the nonresident's principal place of
business is located.
17.7. A contract is not awarded until formal City Council authorization. If the Contract is
to be awarded, City will award the Contract within 90 days after the day of the Bid
opening unless extended in writing. No other act of City or others will constitute
acceptance of a Bid. Upon the contract award, a Notice of Award will be issued by
the City.
17.7. L The contractor is required to fill out and sign the Certificate of Interested
Parties Form 1295 and the form must be submitted to the Project Manager
before the contract will be presented to the City Council. The form can be
obtained at https://www.ethics.state.tX.us/data/forms/1295/1295.pdf
17.8. Failure or refusal to comply with the requirements may result in rejection of Bid.
18. Signing of Agreement
18.1. When City issues a Notice of Award to the Successful Bidder, it will be accompanied
by the required number of unsigned counterparts of the Project Manual. Within 14
days thereafter, Contractor shall sign and deliver the required number of counterparts
of the Project Manual to City with the required Bonds, Certificates of Insurance, and
all other required documentation.
18.2. City shall thereafter deliver one fully signed counterpart to Contractor.
END OF SECTION
CITY OF FORT WORTH 2O26 ASPHALT RESURFACING CONTRACT 3
STANDARD CONSTRUCTION SPECIFICATION DOCUMENT CITY PROJECT NO. 106175
Revised/Updated June 13, 2025
00 35 13
BID FORM
Page 1 of 9
SECTION 00 35 13
CONFLICT OF INTEREST STATEMENT
Each bidder, offeror or respondent to a City of Fort Worth procurement is required to complete a
Conflict of Interest Questionnaire or certify that one is current and on file with the City Secretary's
Office pursuant to state law.
If a member of the Fort Worth City Council, any one or more of the City Manager or Assistant
City Managers, or an agent of the City who exercise discretion in the planning, recommending,
selecting or contracting with a bidder, offeror or respondent is affiliated with your company, then
a Local Government Officer Conflicts Disclosure Statement (CIS) may be required.
You are urged to consult with counsel regarding the applicability of these forms and Local
Government Code Chapter 176 to your company.
The referenced forms may be downloaded from the links provided below.
Form CIQ (Conflict of Interest Questionnaire) (state.tx.us)
https://www. eth ics.state. bc. us/data/forms/conflict/CI S. pdf
❑
0
❑
❑
�
❑
BIDDER:
CIQ Form does not apply
CIQ Form is on file with City Secretary
CIQ Form is being provided to the City Secretary
CIS Form does not apply
CIS Form is on File with City Secretary
CIS Form is being provided to the City Secretary
By:
Signature:
Title:
END OF SECTION
CITY OF FORT WORTH
STANDARD CONSTRUCTION SPECIFICATION DOCUMENTS
Revised 9/30/2021
ARRY GLARK
� ��
PRESIDENT
2026 ASPHALT RESURFACING CONTRACT 3
106175
2-00 41 00 Bid Proposal Workbook
00 41 00
BID FORM
Page 1 of 3
SECTION 00 41 00
BID FORM
TO:
FOR:
The Purchasing Manager
c/o: The Purchasing Division
200 Texas Street
City of Fort Worth, Texas 76102
City Project No.
Units/Sections:
106175
Asphalt Paving
1. Enter Into Agreement
2026 ASPHALT RESURFACING CONTRACT 3
The undersigned Bidder proposes and agrees, if this Bid is accepted, to enter into an Agreement with City in the form
included in the Bidding Documents to perform and furnish all Work as specified or indicated in the Contract Documents
for the Bid Price and within the Contract Time indicated in this Bid and in accordance with the other terms and
conditions of the Contract Documents.
2. BIDDER Acknowledgements and Certification
2.1. In submitting this Bid, Bidder accepts all of the terms and conditions of the INVITATION TO BIDDERS and
INSTRUCTIONS TO BIDDERS, including without limitation those dealing with the disposition of Bid Bond.
2.2. Bidder is aware of all costs to provide the required insurance, will do so pending contract award, and will
provide a valid insurance certificate meeting all requirements within 14 days of notification of award.
2.3. Bidder certifies that this Bid is genuine and not made in the interest of or on behalf of any undisclosed
individual or entity and is not submitted in conformity with any collusive agreement or rules of any group,
association, organization, or corporation.
2.4. Bidder has not directly or indirectly induced or solicited any other Bidder to submit a false or sham Bid.
2.5. Bidder has not solicited or induced any individual or entity to refrain from bidding.
2.6. Bidder has not engaged in corrupt, fraudulent, collusive, or coercive practices in competing for the Contract.
For the purposes of this Paragraph:
a. "corrupt practice" means the offering, giving, receiving, or soliciting of any thing of value likely to
influence the action of a public official in the bidding process.
b. "fraudulent practice" means an intentional misrepresentation of facts made (a) to influence the
bidding process to the detriment of City (b) to establish Bid prices at artificial non-competitive
levels, or (c) to deprive City of the benefits of free and open competition.
c. "collusive practice" means a scheme or arrangement between two or more Bidders, with or
without the knowledge of City, a purpose of which is to establish Bid prices at artificial, non-
competitive levels.
CITY OF FORT WORTH 2O26 ASPHALT RESURFACING CONTRACT 3
STANDARD CONSTRUCTION SPECIFICATION DOCUMENTS 106175
Revised 9J30/2021 2-00 41 00 Bid Proposal Workbook
00 41 00
BID FORM
Page 2 of 3
d. "coercive practice" means harming or threatening to harm, directly or indirectly, persons or their
property to influence their participation in the bidding process or affect the execution of the
Contract.
3. Prequalification
The Bidder acknowledges that the following work types must be performed only by prequalified contractors and
subcontractors:
a. Asphalt Paving Heavy Maintenance (1,000,000 and Over)
b. Not Applicable
c. Not Applicable
d. Not Applicable
e. Not Applicable
f. Not Applicable
g. Not Applicable
h. Not Applicable
4. Time of Completion
4.1. The Work will be complete for Final Acceptance within 180 days after the date when the
the Contract Time commences to run as provided in Paragraph 2.03 of the General Conditions.
4.2. Bidder accepts the provisions of the Agreement as to liquidated damages in the event of failure to complete
the Work {and/or achievement of Milestones} within the times specified in the Agreement.
5. Attached to this Bid
The following documents are attached to and made a part of this Bid:
a. This Bid Form, Section 00 41 00
b. Required Bid Bond, Section 00 43 13 issued by a surety meeting the requirements of Paragraph
5.01 of the General Conditions.
c. Proposal Form, Section 00 42 43
d. Vendor Compliance to State Law Non Resident Bidder, Section 00 43 37
e. MWBE Forms (optional at time of bid)
f. Prequalification Statement, Section 00 45 12
g. Conflict of Interest Affidavit, Section 00 35 13
*If necessary, CIQ or CIS forms are to be provided directly to City Secretary
h. Any additional documents that may be required by Section 12 of the Instructions to Bidders
CITY OF FORT WORTH 2O26 ASPHALT RESURFACING CONTRACT 3
STANDARD CONSTRUCTION SPECIFICATION DOCUMENTS 106175
Revised 9/3012021 2-00 41 00 Bid Proposal Workbook
00 41 00
BID FORM
Page 3 of 3
6. Total Bid Amount
6.1. Bidder will complete the Work in accordance with the Contract Documents for the following bid amount. In
the space provided below, please enter the total bid amount for this project. Only this figure will be read
publicly by the City at the bid opening.
6.2. It is understood and agreed by the Bidder in signing this proposal that the total bid amount entered below is
subject to verification and/or modification by multiplying the unit bid prices for each pay item by the
respective estimated quantities shown in this proposal and then totaling all of the extended amounts.
6.3.
Total Bid
$2,998,544.50
7. Bid Submittal
This Bid is submitted on
RespectFully sub ' d,
y ��
B . (Sign�"'�ur�'j------
J. Barry Clark
(Printed Name)
by the entity named below.
Receipt is acknowledged of the
following Addenda:
Addendum No. 1:
Addendum No. 2:
Addendum No. 3:
Addendum No. 4:
Title: President
Company: Peachtree Construction, LTD
Corporate Seal:
Address: 5801 Park Vista Circle
Fort Worth, TX 76244
State of Incorporation: Texas
Email: JBClark@peachtreecon.com
Phone: 817-741-4658
END OF SECTION
Initial
CITY OF FORT WORTH 2O26 ASPHALT RESURFACING CONTRACT 3
STANDARD CONSTRUCTION SPECIFICATION DOCUMENTS 106175
Revised 9l30/2021 2-00 41 00 Bid Proposal Workbook
00 42 43
BID FORM
Page 1 of 1
SECTION 00 42 43
PROPOSALFORM
UNIT PRICE BID
Project Item Information
Bidlist
Item No.
I 1
I 2
I 3
I �
I 5
I 6
I �
I 8
I �
I l0
I ll
I l2
� 13
� 74
I 15
I 16
I U
I l8
I l9
I 20
� 2l
I 22
I 23
I za
I 25
I 26
I `7
I 2R
I 29
I 30
� 3l
I 32
I 33
I 34
I 35
I 36
I 37
I 38
Description
0135.0201 Remobilization
0241.1300 Remove Conc Curb & Gutter
3216.0102 7" Conc Cl�rb And Gutter
0241.0401 Remove Concrete Driveway
3213.0401 6" Concrete Driveway
0241.0100 Remove Sidewalk
3213.0301 4" Conc Sidewalk
0241.1400 Removc Conc Valley Gutter
3216.0301 7" Conc Valley Gutter
3212.0304 2" Asphalt Pvmt Supe�pave SP-D
0241.1506 2" Surface Milling
3124.0101 Asphalt Pavement Base Repair
9999.0000 Cemen[ Treated Base - Class L
3212.0305 3" Asphalt Pvmt Superpave SP-D
3212.0600 HMAC Pavement Level Up
0241.1700 PavementPulverizarion 11"
3211.0122 Flex Base, Type A, Gr2
3211.0601 CemlimeT"' @ 32 Lbs/Sy
3123.0101 Uoolassified Excevation
3292.0100 Block Sod Replacement
32ll.5001 Curb AdiEss Painting
3291.0100 Topsoil
0241.0300 Remove ADA Ramp
3213.0501 Barrier Free Ramp, Type R-I
3213.0504 Barrier Free Ramp, Type M2
3213.0506 Barriec Free Ramp, Type P-1
9999.1000 Irrigation Adjushnent & Landscape Repair AlLowance
3305.0117 Concrete Collar For VaLve
3305.011 2 Concrete Collar For Manhole
3305.0107 Manhole Adjustment, Minor
3305.0111 Valve Box Adjustment
3ll 0.0101 Site Clearing
3217.0102 6" Sld Pvmt Markin� I IAS (Y)
321 72103 Furnish/Install 4" Reflective Marker, Type II- A/A
3217.0501 24" Sld Pvmt Marking HAE (W)
3212.0401 HMAC Transition
3471.0001 Traffic ConttoL
9999.1003 Paving Constnaction Allowance
Bidder's Application
Bidder's Proposal
Specification
Section No.
01 70 00
02 41 l5
32 16 13
0241 13
327320
0241 l3
32 13 20
32 13 20
32 16 l3
32 12 16
02 41 15
32 01 17
TxDOT 276
3212 16
3212 16
0241 l5
32 11 23
32 11 29
3l 23 23
32 92 13
32 17 25
32 91 19
U2 41 13
32 13 20
32 13 20
32 13 20
99 99 00
33 OS 17
33 OS 17
33 OS 14
33 OS 14
31 10 00
32 17 23
32 17 23
32 17 23
32 12 l6
34 71 l3
99 99 00
Unit of Bid
Unit Price Bid Value
Measure Quantiry
EA 1 54,000.00 $4,000.00
LF 100 4.65 $465.00
LF 100 52.75 $5,275.00
SF 7,000 3.5 $3,500.00
SF 7,000 14 $14,000.00
SF 3,300 2.95 $9,735.00
SF 3300 L325 $43,725.00
SY 315 28 $8,820.00
SY 315 L45 $45,675.00
SY 65,672 l7 $1,I16,424.00
SY 65,672 295 $18Q598.00
CY 24 L100 $26,400.00
CY 30 275 $8,250.00
SY 26,450 25.85 $683,732.50
TN 70 375 $3,750.00
SY 26,450 $825 $218,212.50
CY 50 S110.00 $5,500.00
TN 424 54L0.00 $173,840.00
CY 200 555.00 $11,000.00
SY 50 S45.00 $2,250.00
EA 6 S I50.00 $900.00
CY 100 S75.00 $7,500.00
EA 42 51,000.00 $42,000.00
EA 36 S3,000.00 $108,000.00
EA 1 SA,000.00 $4,000.00
EA 5 53,550.00 $17,750.00
LS 1 525,000.00 $25,000.00
EA l0 SL200.00 $12,000.00
EA l0 SL,450.00 $14,500.00
EA l0 5550.00 $5,500.00
EA 10 5330.00 $3,300.00
SY 100 555.00 $S,S00.00
LF 1,000 52.85 $2,850.00
EA 25 59.50 $237.50
LF 60 S13 ?5 $855.00
TN IO 5350.00 $3,500.00
MO 6 55,000.00 $30,000.00
LS 1 SLSQ000.00 $150,000.00
Total Bid $2,998,544.50
GPD OF SLCTIOn
GTY OF FORT WORTH 2O26 ASPHALT RESURFACING CONTRACT 3
STANDARD CONSTRUCTION SPECIFICATION DOCUMENTS 106175
Revised 9/30/2021 2-00 41 00 Bid Proposal Workbook
00 43 13
BID FORM
Page 1 of 2
SECTION 00 43 13
BID BOND
KNOW ALL BY THESE PRESENTS:
That we, Peachtree Construction, Ltd. , known as
"Bidder" herein and Travelers Casualty and Surety Company of America a corporate surety
duly authorized to do business in the State of Texas, known as "Surety" herein, are held and firmly bound unto the
City of Fort Worth, a municipal corporation created pursuant to the laws of Texas, known as "City" herein, in the penal
sum of five percent (5%) of Bidder's maximum bid price, in lawful money of the United States, to be paid in Fort
Worth, Tarrant County, Texas for the payment of which sum well and truly to be made, we bind ourselves, our heirs,
executors, administrators, successors and assigns, jointly and severally, firmly by these presents.
WHEREAS, the Principal has submitted a bid or proposal to perform Work for the following project
designated as 2026 ASPHALT RESURFACING CONTRACT 3
NOW, THEREFORE, the condition of this obligation is such that if the City shall award
the Contract for the foregoing project to the Principal, and the Principal shall satisfy all requirements and conditions
required for the execution of the Contract and shall enter into the Contract in writing with the City in accordance with
the terms of such same, then this obligation shall be and become null and void. If, however, the Principal fails to
execute such Contract in accordance with the terms of same or fails to satisfy all requirements and conditions
required for the execution of the Contract, this bond shall become the property of the City, without recourse of the
Principal and/or Surety, not to exceed the penalty hereof, and shall be used to compensate City for the difference
between Principal's total bid amount and the next selected bidder's total bid amount.
PROVIDED FURTHER, that if any legal action be filed on this Bond, venue shall lie in Tarrant County,
Texas or the United States District Court for the Northern District of Texas, Fort Worth Division.
IN WITNESS WHEREOF, the Principal and the Surety have SIGNED and SEALED this instrument by
duly authorized agents and officers on this the 18th day of September , 2025.
ATTEST:
Witness as to P ncipal '
PRINCIPAL:
Peachtree Construction, Ltd.
BY: . �
Si�ature : �
J. BARRY CLARK
Name and Title
� —
CITY OF FORT WORTH
STANDARD CONSTRUCTION SPECIFICATION DOCUMENTS
Revised 9/30I2021
Addr'ess: 5801 Park Vista Cir.
Keller, TX 76244
PRESIDENT
SU RETY:
Travelers Casualty and Surety Company of America
�
2026 ASPHALT RESURFACING CONTRACT 3
106175
00 41 DO Bid Proposal Workbook
004313
BID FORM
Page 2 of 2
/1..�/JJ�I._ _�Q.-�-
`��-`' Signatu e �
��� ��
Witness as to Surety grisa Reyes - Agent
Attach Power of Attorney (Surety) for Attorney-in-Fact
Teresa Ayala Atty-in-Fact
Name and Title
AddreSs: 9601 McAllister Freeway suite 7�0
San Antonio, TX 78216
Telephone Number: soo-z3s-sz25
*Note: If signed by an officer of the Surety Company, there must be on file a certified extract from the by laws
showing that this person has authority to sign such obligation. If Surety's physical address is different from
its mailing address, both must be provided. The date of the bond shail not be prior to the date the Contract
is awarded.
END OF SECTION
CITY OF FORT WORTH 2O26 ASPHALT RESURFACING CONTRACT 3
STANDARD CONSTRUCTION SPECIFICATION DOCUMENTS 106175
Revised 9/30/2D21 00 41 00 Bid Proposal Workbook
Travelers Casualty and Surety Company of America
� Travelers Casualty and Surety Company
TRAVELERS � St. Paul Fire and Marine Insurance Company
POWER OF ATTORNEY
KNOW ALL MEN BY THESE PRESENTS: That Travelers Casualty and Surety Company of America, Travelers Casualty and Surety Company, and
St. Paul Fire and Marine Insurance Company are corporations duly organized under the laws of the State of Connecticut (herein
collectively called the "Companies"), and that the Companies do hereby make, constitute and appoint Teresa Ayala of
FT WORTH , Texas , their true and lawful Attorney(s)-in-Fact to sign, execute, seal and
acknowledge any and all bonds, recognizances, conditional undertakings and other writings obligatory in the nature thereof on behalf of
the Companies in their business of guaranteeing the fidelity of persons, guaranteeing the perFormance of contracts and executing or
guaranteeing bonds and undertakings required or permitted in any actions or proceedings allowed by law.
IN WITNESS WHEREOF, the Companies have caused this instrument to be signed, and their corporate seals to be hereto affixed, this 21st day of April,
2021.
��-,,,...rtrtrt ��y.,�
��__"/3� � eJ?tSY AN-08 �y�'-*.
4p GPy
, ��� � t4AF:TF�f�� � � �I�;l�. �.
�'� � CONH. �0 1� .
� r".,� `�y� aM A �� * �
• a '� dt hPy "f+�
State of Connecticut
City of Hartford ss.
: �
By: „Y�
Robert L. Rane , enior Vice President
On this the 21st day of April, 2021, before me personally appeared Robert L. Raney, who acknowledged himself to be the Senior
Vice President of each of the Companies, and that he, as such, being authorized so to do, executed the foregoing instrument for the
purposes therein contained by signing on behalf of said Companies by himself as a duly authorized officer.
IN WITNESS WHEREOF, I hereunto set my hand and official seal.
My Commission expires the 30th day of June, 2026
.�•'�"c`+J�j'..
r��trg'f y��•. �. '�J/ ,�J
nat�.nr i J/����.r V I'�����
#* .W,w *n
i a��a'`�o # 'S
,� Anna P. Nowik, Notary Public
`�,�;�...��''
This Power of Attorney is granted under and by the authority of the following resolutions adopted by the Boards of Directors of each of
the Companies, which resolutions are now in full force and effect, reading as follows:
RESOLVED, that the Chairman, the President, any Vice Chairman, any Executive Vice President, any Senior Vice President, any Vice
President, any Second Vice President, the Treasurer, any Assistant Treasurer, the Corporate Secretary or any Assistant Secretary may appoint
Attorneys-in-Fact and Agents to act for and on behalf of the Company and may give such appointee such authority as his or her certificate of authority
may prescribe to sign with the Company's name and seal with the Company's seal bonds, recognizances, contracts of indemnity, and other writings
obligatory in the nature of a bond, recognizance, or conditional undertaking, and any of said officers or the Board of Directors at any time may
remove any such appointee and revoke the power given him or her; and it is
FURTHER RESOLVED, that the Chairman, the President, any Vice Chairman, any Executive Vice President, any Senior Vice President or
any Vice President may delegate all or any part of the foregoing authority to one or more officers or employees of this Company, provided
that each such delegation is in writing and a copy thereof is filed in the office of the Secretary; and it is
FURTHER RESOLVED, that any bond, recognizance, contract of indemnity, or writing obligatory in the nature of a bond, recognizance,
or conditional undertaking shall be valid and binding upon the Company when (a) signed by the President, any Vice Chairman, any Executive
Vice President, any Senior Vice President or any Vice President, any Second Vice President, the Treasurer, any Assistant Treasurer, the
Corporate Secretary or any Assistant Secretary and duly attested and sealed with the Company's seal by a Secretary or Assistant Secretary;
or (b) duly executed (under seal, if required) by one or more Attomeys-in-Fact and Agents pursuant to the power prescribed in his or her
certificate or their certificates of authority or by one or more Company officers pursuant to a written delegation of authority; and it is
FURTHER RESOLVED, that the signature of each of the following officers: President, any Executive Vice President, any Senior Vice President,
any Vice President, any Assistant Vice President, any Secretary, any Assistant Secretary, and the seal of the Company may be affixed by facsimile to
any Power of Attorney or to any certificate relating thereto appointing Resident Vice Presidents, Resident Assistant Secretaries or Attomeys-in-
Fact for purposes only of executing and attesting bonds and undertakings and other writings obligatory in the nature thereof, and any such Power of
Attorney or certificate bearing such facsimile signature or facsimile seal shall be valid and binding upon the Company and any such power so executed
and certified by such facsimile signature and facsimile seal shall be valid and binding on the Company in the future with respect to any bond or
understanding to which it is attached.
I, Kevin E. Hughes, the undersigned, Assistant Secretary of each of the Companies, do hereby certify that the above and foregoing is a
true and correct copy of the Power of Attorney executed by said Companies, sti�Fiich i-tmains in full force and effect.
Dated this 18th day of September , 2025
�/VW'wN[IYpCp �JaitY Ahq ,�vy ��
. �[Jj�,/,�'''' T� U P�'8� S * �y.
t tlkRTfi�1l � W HIUiYFqRD. � G+�1.�4
t axa+. e c�. g ��
{��a �
�j'^. ,��\j� �y� ^�dbr #� �
� �
Kevin E. Hughes, Assi� retary
To verity the authenticity of this Powe� ofAhtorney, p/ease ca// us at 1-800-421-3880.
P/ease refer to the above-named Ahtorney(s)-in-Fact and the detai/s of the bond to which ifiis Powe� ofAttorney is attached.
00 43 37
BID FORM
Page8of9
SECTION 00 43 37
VENDOR COMPLIANCE TO STATE LAW NON RESIDENT BIDDER
Texas Government Code Chapter 2252 was adopted for the award of contracts to nonresident bidders. This law
provides that, in order to be awarded a contract as low bidder, nonresident bidders (out-of-state contractors
whose corporate offices or principal place of business are outside the State of Texas) bid projects for
construction, improvements, supplies or services in Texas at an amount lower than the lowest Texas resident
bidder by the same amount that a Texas resident bidder would be required to underbid a nonresident bidder in
order to obtain a comparable contract in the State which the nonresident's principal place of business is located.
The appropriate blanks in Section A must be filled out by all nonresident bidders in order for your bid to meet
specifications. The failure of nonresident bidders to do so will automatically disqualify that bidder. Resident
bidders must check the box in Section B.
A. Nonresident bidders in the State of , our principal place of business,
are required to be percent lower than resident bidders by State Law, A copy of the
statute is attached.
Nonresident bidders in the State of , our principal place of business,
are not required to underbid resident bidders.
B. The principal place of business of our company or our parent company or majority owner is
in the State of Texas. �
BIDDER:
By: J. Barry Clark
�. � . �
� (Sigr�ature�r
Title: President
Date:
END OF SECTION
CITY OF FORT WORTH
STANDARD CONSTRUCTION SPECIFICATION DOCUMENTS
Revised 9l30/2021
9/18/2025
2026 ASPHALT RESURFACING CONTRACT 3
106175
2-00 41 00 Bid Proposal Workbook
00 45 12
PREQUALIFICATION STATEMENT
Page 9 of 9
SECTION 00 45 12
PREQUALIFICATION STATEMENT
Each Bidder for a City procurement is required to complete the information below by identifying the prequalified
contractors and/or subcontractors whom they intend to utilize for the major work type(s} listed.
Major Work Type
Asphalt Paving Heavy
Maintenance (1,000,000 and
Over)
Not Applicable
Not Applicable
Not Applicable
Not Applicable
Not Applicable
Not Applicable
Not Applicable
Contractor/Subcontractor Company Name
Peachtree Construction, LTD.
Prequalification
Expiration Date
10/2/2026
The undersigned hereby certifies that the contractors and/or subcontractors described in the table above are
currently prequalified for the work types listed.
BIDDER:
Peachtree Construction, LTD
5801 Park Vista Circle
Fort Worth, TX 76244
0
By: J. Barry rk
J. -� �'
(Signature)
Title: President
Date:
END OF SECTION
CITY OF FORT WORTH
STANDARD CONSTRUCTION SPECIFICATION DOCUMENTS
Revised 09/30/2021
`�- I�c-ZS'
2025 CONCRETE RESTORATION CONTRACT 1
105046
2-00 41 00 Bid Proposal Workbook
00 52 43 - I
Agreement
Page 1 of 7
SECTION 00 52 43
AGREEMENT
THIS AGREEMENT, authorized on December 9, 2025, is made by and between the City of Fort
Worth, a Texas home rule municipality, acting by and through its duly authorized City Manager,
("City"), and Peachtree Construction, Ltd., authorized to do business in Texas, acting by and
through its duly authorized representative, ("Contractor"). City and Contractor may jointly be
referred to as Parties.
City and Contractor, in consideration of the mutual covenants hereinafter set forth, agree as follows:
Article 1. WORK
Contractor shall complete all Work as specified or indicated in the Contract Documents for the
Project identified herein.
Article 2. PROJECT
The project for which the Work under the Contract Documents may be the whole or only a part is
generally described as follows:
2026 ASPHALT RESURFACING CONTRACT 3
CITY PROJECT NUMBER 106175
Article 3. CONTRACT PRICE
City agrees to pay Contractor for performance of thc Work in accordance with the Contract
Documents an amount, in current funds, of TWO MILLION NINE HUNDRED NINETY-
EIGHT THOUSAND, FIVE HUNDRED FORTY-FOUR AND 50/100 DOLLARS
($2,998,544.50). Contract price may be adjusted by change orders duly authorized by the Parties.
Article 4. CONTRACT TIME
4.1 Final Acceptance.
The Wark shall be complete for Final Acceptance within 180 days after the date when the
Contract Time commences to run, as provided in Paragraph 2.02 of the General Conditions,
plus any extension thereof allowed in accordance with Article 12 of the General Conditions.
4.2 Liquidated Damages
A.Contractor recognizes that time is of the essence for completion of Milestones, if any, and
to achieve Final Acceptance of the Work and City and the public will suffer from loss of
use if the Work is not completed within the time(s) specified in Paragraph 4.1 above. The
Contractor also recognizes the delays, expense and diffculties involved in proving in a
legal proceeding, the actual loss suffered by the City if the Work is not completed on time.
Accordingly, instead of requiring any such proof, Contractor agrees that as liquidated
damages for delay (but not as a penalty), Contractor shall pay City Six Hundred Fifty AND
00/100 Dollars ($650.00) for each day that expires after the time specified in Paragraph 4.1
for Final Acceptance unril the City issues the Final Letter of Acceptance.
OFFICIAL RECORD
CITY SECRETARY
FT. WORTH, TX
CITY OF FORT WORTH 2O26 ASPHALT RESURFACING CONTRACT 3
STANDARD CONSTRUCTION SPECIFICATION DOCUMENTS CITY PROJECT NO. 106175
Revised August 18, 2025
00 52 43 - 2
Agreement
Page 2 of 7
Article 5. CONTRACT DOCUMENTS
5.1 CONTENTS:
A.The Contract Documents which comprise the entire agreement between City and
Contractor concerning the Work consist of the following:
L This Agreement.
2. Attachments to this Agreement:
a. Bid Form
1) Proposal Form
2) Vendor Compliance to State Law Non-Resident Bidder
3) Prequalification Statement
4) State and Federal documents (project specific)
b. Current Prevailing Wage Rate Table
c. Insurance Certiiication Form (ACORD or equivalent)
d. Payment Bond
e. Performance Bond
£ Maintenance Bond
g. Power of Attorney for the Bonds
h. Worker's Compensation Affidavit
3. General Conditions.
4. Supplementary Conditions.
5. Specifications specifically made a part of the Contract Documents by attachment or,
if not attached, as incorporated by reference and described in the Table of Contents
of the Project's Contract Documents.
6. Drawings.
7. Addenda.
8. Documentation submitted by Contractor prior to Notice of Award.
9. The following which may be delivered or issued after the Effective Date of the
Agreement and, if issued, become an incorporated part of the Contract Documents:
a. Notice to Proceed.
b. Field Orders.
c. Change Orders.
d. Letter of Final Acceptance.
Article 6. INDEMNIFICATION
�FFICIAL RECORD
CITY SECRETARY
FT. WORTH, TX
CITY OF FORT WORTH 2O26 ASPHALT RESURFACING CONTRACT 3
STANDARD CONSTRUCTION SPECIFICATION DOCUMENTS CITY PROJECT NO. 106175
Revised August 18, 2025
005243-3
Agreement
Page 3 of 7
6.1 Contractor covenants and agrees to indemnify, hold harmless and defend, at its own
expense, the city, its officers, servants and employees, from and against any and all
claims arising out of, or alleged to arise out of, the work and services to be performed
by the contractor, its officers, agents, employees, subcontractors, licenses or invitees
under this contract. This indemnification provision is snecificallv intended to ouerate
and be effective even if it is alleged or proven that aII or some of the dama�es bein�
sought were caused, in whole or in part, bv anv act, omission or ne�li�ence of the citv.
This indemnity provision is intended to include, without limitation, indemnity for costs,
expenses and legal fees incurred by the city in defending against such claims and causes
of actions.
6.2 Contractor covenants and agrees to indemnify and hold harmless, at its own expense,
the city, its officers, servants and employees, from and against any and all loss, damage
or destruction of property of the city, arising out of, or alleged to arise out of, the work
and services to be performed by the contractor, its officers, agents, employees,
subcontractors, licensees or invitees under this contract. This indemnification provision
is specificallv intended to operate and be effective even if it is alle�ed or proven that all
or some of the damages being sou�ht were caused, in whole or in part, bv anv act,
omission or ne�ligence of the citv.
Article 7. MISCELLANEOUS
71 Terms.
Terms used in this Agreement which are defined in Article 1 of the General Conditions will
have the meanings indicated in the General Conditions.
7.2
7.3
Assignment of Contract.
This Agreement, including all of the Contract Documents may not be assigned by the
Contractor without the advanced express written consent of the City.
Successors and Assigns.
City and Contractor each binds itself, its partners, successors, assigns and legal
representatives to the other party hereto, in respect to all covenants, agreements and
obligations contained in the Contract Documents.
7.4 Severability/Non-Waiver of Claims.
Any provision or part of the Contract Documents held to be unconstitutional, void or
unenforceable by a court of competent jurisdiction shall be deemed stricken, and all
remaining provisions shall continue to be valid and binding upon City and Contractor.
The failure of City or Contractor to insist upon the performance of any term or provision of
this Agreement or to exercise any right granted herein shall not constitute a waiver of City's
or Contractor's respective right to insist upon appropriate performance or to assert any such
right on any future occasion.
OFFICIAL RECORD
%.S GOVeClllllg L1W c1Y1Cl Ve11Ue. CITY SECRETARY
FT. WORTH, TX
This Agreement, including all of the Contract Documents is performable in tne �tate of
Texas. Venue shall be Tarrant County, Texas, or the United States District Court for the
Northern District of Texas, Fort Worth Division.
CITY OF FORT WORTH 2O26 ASPHALT RESURFACING CONTRACT 3
STANDARD CONSTRUCTION SPECIFICATION DOCUMENTS CITY PROJECT NO. 106175
Revised August 18, 2025
005243-4
Agreement
Page 4 of 7
7.6
Authority to Sign.
Contractor shall attach evidence of authority to sign Agreement if signed by someone other
than the duly authorized signatory of the Contractor.
7.7
Non-appropriation of Funds.
In the event no funds or insufficient funds are appropriated by City in any fiscal period for
any payments due hereunder, City will notify Vendor of such occurrence and this Agreement
shall terminate on the last day of the fiscal period for which appropriations were received
without penalty or expense to City of any kind whatsoever, except as to the portions of the
payments herein agreed upon for which funds have been appropriated.
:
Prohibition On Contracts With Companies Boycotting Israel.
Contractor, unless a sole proprietor, acknowledges that in accordancc with Chapter 2271 of
the Texas Government Code, if Contractor has 10 or more full time-employees and the
contract value is $100,000 or more, the City is prohibited from entering into a contract with
a company for goods or services unless the contract contains a written verification from the
company that it: (1) does not boycott Israel; and (2) will not boycott Israel during the term of
the contract. The terms "boycott Israel" and "company" shall have the meanings ascribed to
those terms in Section 808.001 of the Texas Government Code. By signing this contract,
Contractor certifies that Contractor's signature provides written verification to the
City that if Chapter 2271, Texas Government Code applies, Contractor: (1) does not
boycott Israel; and (2) will not boycott Israel during the term of the contract.
7.9
Prohibition on Boycotting Energy Companies.
Contractor acknowledges that in accordance with Chapter 2276 of the Texas Government
Code, the City is prohibited from entering into a contract for goods or services that has a
value of $100,000 or more, which will be paid wholly or partly from public funds of the City,
with a company (with 10 or more full-time employees) unless the contract contains a written
verification from the company that it: (1) does not boycott energy companies; and (2) will
not boycott energy companies during the term of the contract. The terms "boycott energy
company" and "company" have the meaning ascribed to those terms by Chapter 2276 of the
Texas Government Code. To the extent that Chapter 2276 of the Government Code is
applicable to this Agreement, by signing this Agreement, Contractor certifies that
Contractor's signature provides written veri�ication to the City that Contractor: (1)
does not boycott energy companies; and (2) will not boycott energy companies during
the term of this Agreement.
7.10 Prohibition on Discrimination Against Firearm and Ammunition Industries.
C�7��[y1,1�:�X�%]:a��
C«] � i'�'i Xy:� � ��1:�'1
FT. WORTH, TX
CITY OF FORT WORTH 2O26 ASPHALT RESURFACING CONTRACT 3
STANDARD CONSTRUCTION SPECIFICATION DOCUMENTS CITY PROJECT NO. 106175
Revised August 18, 2025
005243-5
Agreement
Page 5 of 7
Contractar acknowledges that except as otherwise provided by Chapter 2274 of the Texas
Government Code, the City is prohibited from entering into a contract for goods ar services
that has a value of $100,000 or more which will be paid wholly or partly from public funds
of the City, with a company (with 10 or more full-time employees) unless the contract
contains a written veriiication from the company that it: (1) does not have a practice, policy,
guidance, or directive that discriminates against a iirearm entity or firearm trade association;
and (2) will not discriminate during the term of the contract against a firearm entity or firearm
trade association. The terms "discriminate," "firearm entity" and "firearm trade association"
have the meaning ascribed to those terms by Chapter 2274 of the Texas Government
Code. To the extent that Chapter 2274 of the Government Code is applicable to this
Agreement, by signing this Agreement, Contractor certifies that Contractor's signature
provides written verification to the City that Contractor: (1) does not have a practice,
policy, guidance, or directive that discriminates against a firearm entity or firearm
trade association; and (2) will not discriminate against a firearm entity or firearm trade
association during the term of this Agreement.
�FFIGIAL RECORD
CITY SECRETARY
FT. WORTH, TX
CITY OF FORT WORTH 2O26 ASPHALT RESURFACING CONTRACT 3
STANDARD CONSTRUCTION SPECIFICATION DOCUMENTS CITY PROJECT NO. 106175
Revised August 18, 2025
00 52 43 - 6
Agreement
Page 6 of 7
7.11 Immigration Nationality Act.
Contractor shall verify the identity and employment eligibility of its employees who perform
work under this Agreement, including completing the Employment Eligibility Verification
Form (I-9). Upon request by City, Contractor shall provide City with copies of all I-9 forms
and supporting eligibility documentation for each employee who performs work under this
Agreement. Contractor shall adhere to all Federal and State laws as well as establish
appropriate procedures and controls so that no services will be performed by any Contractor
employee who is not legally eligible to perform such services. CONTRACTOR SHALL
INDEMNIFY CITY AND HOLD CITY HARMLESS FROM ANY PENALTIES,
LIABILITIES, OR LOSSES DUE TO VIOLATIONS OF THIS PARAGRAPH BY
CONTRACTOR, CONTRACTOR'S EMPLOYEES, SUBCONTRACTORS,
AGENTS, OR LICENSEES. City, upon written notice to Contractor, shall have the right
to immediately terminate this Agreement for violations of this provision by Contractor.
712 No Third-Party Beneficiaries.
This Agreement gives no rights or benefits to anyone other than the City and the Contractor
and there are no third-party beneficiaries.
7.13 No Cause of Action Against Engineer.
Contractor, its subcontractors and equipment and materials suppliers on the PROJECT or their
sureties, shall maintain no direct action against the Engineer, its officers, employees, and
subcontractors, for any claim arising out of, in connection with, or resulting from the engineering
services performed. Only the City will be the beneficiary of any undertaking by the Engineer.
The presence or duties of the Engineer's personnel at a construction site, whether as on-site
representatives or otherwise, do not make the Engineer or its personnel in any way
responsible for those duties that belong to the City and/or the City's construction contractors
or other entities, and do not relieve the construction contractars or any other entity of their
obligations, duties, and responsibilities, including, but not limited to, all construction
methods, means, techniques, sequences, and procedures necessary far coordinating and
completing all portions of the construction work in accordance with the Contract Documents
and any health or safety precautions required by such construction work. The Engineer and
its personnel have no authority to exercise any control over any construction contractor or
other entity or their employees in connection with their work or any health or safety
precautions.
�FFICIAL RECORD
CITY SECRETARY
FT. WQRTH, TX
CITY OF FORT WORTH 2O26 ASPHALT RESURFACING CONTRACT 3
STANDARD CONSTRUCTION SPECIFICATION DOCUMENTS CITY PROJECT NO. 106175
Revised August 18, 2025
005243-7
Agreement
Page 7 of 7
IN WITNESS WHEREOF, City and Contractor have each executed this Agreement to be effective
as of the date subscribed by the City's designated Assistant City Manager ("Effective Date").
Contractor: Peachtree Construction, Ltd.
By:
�l�w.
� ea ��y ca �k (� a �, ,, �me >> sa:aa csr)
Signature
J. Barry Clark
(Printed Name)
President
Tltle
5801 Park Vista Circle
Address
Fort Worth, TX 76244
City/State/Zip
1/5/2026
Date
City of Fort Worth
By:
���� �
�
Jesica McEachern
Assistant City Manager
O1/22/2026
Date o�
v'�4FORT nII
O =°o "aa`Y�9po
♦♦ f�
AlleSt. pv8 �=p
°od*000 o"�'
�^ �" A �� aacn nezps44
�
Jannette Goodall, City Secretary
(Seal)
M&C: 25-1139
Date: 12-9-2025
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.
Zekltn �1re3a
Zelalerr Arega (Jan5,20261137:43 CST,
(Tariqul Islam)
(Proj ect Manager)
Approved as to Form and Legality:
. l�,�
Douglas B.ac� (Jan 9.202616:0532CST)
Douglas W. Black
Sr. Assistant Ciry Attorney
APPROVAL RECOMMENDED:
OFFICIAL RECORD �°�,,,j�,,;,,,,,�
CITY SECRETARY �a�r�r �'r ��r Uan 9,zoze ii zo_n csi;
FT. WORTH, TX Lauren Prieur, Director,
Transportation and Public Works Department
CITY OF FORT WORTH 2O26 ASPHALT RESURFACING CONTRACT 3
STANDARD CONSTRUCTION SPECIFICATION DOCUMENTS CITY PROJECT NO. 106175
Revised August 18, 2025
ooas��-i
CONTRACTOR COMPLIANCE WITH WORKER'S COMPENSnT[ON LAW
Page I of I
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SECTION 00 45 26
CONTRACTOR COMPLIANCE WITH WORKER'S COMPENSATION LAW
Pursuant to Texas Labor Code Section 406.096(a), as amended, Contractor certifies that it
provides worker's compensation insurance coverage for all of its employees employed on City
Project No. 106175. Contractor further certifes that, pursuant to Texas Labor Code, Section
406.096(b), as amended, it will provide to City its subcontractor's certificates of compliance with
worker's compensation coverage.
CONTRACTOR:
PE;4CHiREE CONSiRUCiION,LTD,
Company
Address
5801 PAR'<\'ISTACIR.
KELLER, TX 76244
City/State/Zip
THE STATE OF TEXAS
COUNTY OF TARRANT
By:
Signature
Title:
§
§
J. BARRY CLARK
(Ple Print)
)
. � ` �
� � ---
PRESIDENT
(Please Print)
BEFORE ME, the undersigned authority, on this day personally appeared
J. BARRY CLARK , known to me to be the person whose name is
subscribed to the foregoing instrument, and acknowledged to me that he/she executed the same as
the act and deed of PEACHTREE CONSTRUCTION,LTD. for the purposes and
consideration therein expressed and in the capacity therein stated.
GIV N UNDER MY HAND AND SEAL OF OFFICE this
, 20�s.
Notary P ic in and for the State of Texas
I �`� day of
END OF SECTION
CITY OF FORT W02TH
STANDARD CONSTRUCT[ON SPEC[FICAT[ON DOCUMENTS
Revised July I, 201 I
� Y°� Janet Lynn Reiter
j My Commission Expires
* . * 8/28/2027
Notary ID 13035067�
� � .
2026 ASPHALT RESURFACING CONTRACT 3
C[TY PROJGCT NO. 106175
006113-1
PERFORMANCE BOND
Page 1 of2
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G
THE STATE OF TEXAS
SECTION 00 G1 13
PERFORMANCE BOND
Bond # 108262668
7
8
COUNTY OF TARRANT
§
§ KNOW ALL BY THESE PRESENTS:
§
That we, Peachtree, Construction, Ltd., lcnown as "Principal" herein and
Travelers Casualty and Surety Company of America � a corporate surety(sureties, ii more than
9 one) duly authorized to do business in the State of Texas, lcnown as "Surety" herein (whether one
10 or more), are held and firmly bound unto the City of Fort Worth, a municipal corporation created
11 pursuant to the laws of Texas, lcnown as "City" herein, in the penal sum of, TWO MILLION
12 NINE HUNDRED NINETY-EIGHT THOUSAND. FIVE HUNDRED I�'ORTY-FOUR AND
13 50/100 llOLLARS ($2.998,544.501, lawful money of the United States, to be paid in Fort Worth,
14 Tarrant County, Texas for the payment of which sum well and truly to be made, we bind
l5 ourselves, our heirs, executors, administrators, successora and assigns, jointly and severally,
16
17
firmly by these presents.
WHEREAS, the Principal has entered into a certain written contract with the City
18 awarded the 9t�' day of Deceinber, 2025, which Contract is hereby referred to and made a part
19 hereof for all purposes as if fully set forth herein, to furnish all materials, equipment labor and
20 other accessories defined by law, in the prosecution oithe Worlc, including any Change Orders,
21 as provided for in said Contract designated as 2026 ASPHALT RESURFACING CONTRACT 3.
2? rity—P-r_ojec�N� 1 nh t 75
23 NOW, THEREFORE, the condition of this obligation is such that if the saicl Principal
24 shall faithfully perform it obiigations under the Contract and shall in all respects duly and
25 faithfully perform t11e Work, including Change Orders, under the Contract, according to the plans,
2G specifications, and contract documents therein referred to, and as well during any period of
27 extension of the Contract that inay be granted on the part of the City, then this obligation shall be
28 and become null and void, otherwise to rei�ain in full force and effect, ,
29
3fl
PROVIDED FURTHER, that if any legal action be filed on this Bond, venue shall lie in
Tarrant County, Texas or the United States District Court for the Noi�thern District of Texas, Fort
31 Woi�th Division.
CITY OP FORT WQRTH 2O26 ASPHALT RESURPACING CONTRACT 3
STANDARD CONSTRUCTION SPECIPICATION DOCUMENTS CITY PROJECT NO, 166175
Revised December 8, 2023
0061 13-2
PGRFORMANCC BOND
Pagc ? of 2
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�a
This bond is made and executed in compliance with the provisions of Chapter 2253 of the
Texas Government Code, as amended, and all liabilities on this bond shall be determined in
accordance with the provisions of said statue.
IN WITNESS WHEREOF, the Principal and the Surety have SIGNED and SEALED
tllis instrument by duly authorized agents and officers on this the 29th day of December
, 20 z5 .
PRWCIPAL:
Peachtree Construction Ltd.
. �� �_
BY. 1 �
Signature �
ATTEST:
(Principal) Secreta�y
J. BARRY GLARK
PRESIDENT
Name and Title
Wit ss as to Principal
���V �—''
W itness as to Sucety grisa Reyes - Agent
Address: 5801 Parlc Vista Circle
Port Worth, TX 76244
SURETY:
Travelers Casualty and Surety Company of P,meilca
1 .
� ti r�
BY: � r �(� (.: � �� 't; t ���=-=--
�� _ Signature � %
Teresa Ayala Atty-in-Fact
Name and Title
Address: Z900 Marquita Dr
Fort Worth. TX 76116
Telephone Number: $��-�37-4943
Email Address: TEAyala@Acrisure.com
*Note: If signed by an officer of the Surety Company, there must be on Cle a certified extract
fi-om the by-laws showing that this peison has authority to sign such obligation. If
Surety's physical address is different from its mailing address, both must be provided.
The date of the bond shall not be prior to the date the Contract is awarded.
CITY OF FORT WORTH
STANDARD CONS1'RUCTION SPGCIPICATION DOCUMGNTS
Revised December 8, 2023
2026 A3PI IALT RESURFACING CONTRACT 3
CITY PRO.IGC']' NO. ]06175
00 61 14 - 1
PAYMENTBOND
Page 1 of 2
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SECTION 00 Gl 14
PAYMENT BOND gond # 108262668
§
§ ` KNOW ALL BY THESE PRESENTS:
§
7 That we, Peachtree, Construction, Ltd., lcnown as "Principal" herein, and
8 Travelers Casualty and Surety Company of America , a corporate surety
9 (sureties), duly authorized to do business in the State of Texas, lrnown as "Surety" herein
10 (whether one or more), are held and firmly bound unto the City of Fort Worth, a municipal
11 corporation created pursuant to the laws of the State of Texas, Icnown as "City" herein, in the
12 penal sum of TWO MILLION NINE HUNDRED NINETY-EIGHT THOUSAND, FIVE
13 HUNDRED FORTY-FOUR AND 50/100 DOLLARS ($2.998.54450),, lawful money of the
14 United States, to be paid in Fort Woi�th, Tas•rant County, Texas, for the payment of which sum
15
16
17
18
19 p'urposes as if fully set forth herein, to furnish all materials, equipment, labor and other
20 accessories as defined by 1aw, in the prosecution of the Worlc as provided for in said Contract and
21 designated as 2026 ASPHALT RESURFACING CONTRACT 3, City Project No, 106175.
22 NOW, THEREFORE, THE CONDITION OF THI5 OBLIGATION is such that if
23 Yrincipal shall pay all monies owing to any (and all) payment bond beneficiary (as defined in
24 Chapter 2253 of the Texas Government Code, as amended) in the prosecution of the Worlc under
25 the Contract, then this obligation shall be and Uecome null and vaid; otherwise to remain in full
26 force and effect.
27
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THE STATE OF TEXAS
COUNTY OF TARRANT
well and truly be made, we bind ourselves, our heirs, executors, administrators, successors and
assigns, jointly and severally, firmly by these presents:
WHEREAS, Principal has entered into a certain written Contract with City, awarded the
9'�' day of December. 2025, which Contract is hereby referred to and made a part hereof for all
This bond is made and executed in compliance with the provisions of Chapter 2253 of the
Texas Government Code, as amended, and all liabilities on this bond shall be determined in
accordance with the provisions of said statute.
CITY OP FORT WORTf-I
STANDARD CONSTRUCTION SPECIFICATION DOCUMENTS
Revised December 8, 2023
2026 ASPI-IALT RESURPACING CONTRACT 3
CITY PROJECT NO, f 06175
0061 14-2
PAYMEN"1' BOND
Page 2 of 2
1 IN WITNESS WHEREOF, the Pcincipal and Surety have each SIGNED and SEALED
2 this instrumeilt by du(y authorized agents and officers on this the 29th_ day of
� December 20 25
4
ATTEST:
(Principal) Secretary
Witnes�%as to Pcincipal
PRINCIPAL:
Peachtcee Construction, Ltd.
BY: . J. � �
Stgnature
J. BARRY CLARK
PRESID��T
Name and Title
Address: 5801 Pack Vista Circle
Fort Worth, TX 76244
SURETY:
Travelers Casualty and Surety Company of America
i� , ';
ATTEST: BY: �� G/l;r;::'�� ._ (.: � G�;/[ij_dl_
--` ��ignature � �
(St�rety) Secretary
���� ��l
Witness as to Surety grisa Reyes - Agent
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Teresa Ayala Atty-in-Fact
Name and Title
Addcess: 2900 Marquita Dr
Fort Worth, TX 76116
"Telephone Number: 817-737-4943
Email Address: TEAvala(a�Acrisure.com
Note: If signed by an officer of the Surety, there must be on file a certified extract from the
bylaws showing that this person has authocity to sign sucll obligation. If Surety's physical
address is different fi�om its mailing address, both must be provided.
The date of the bond shall not be prior to the date the Contract is awarded.
ENll OF S�CTION
CITY OP FORT WORTH 2O26 ASPHALT RLSURFACWG CON'CRlACT 3
STANDARD CONS'I'RUCTION SPECIFICATION DOCUMGN7'S CITY PROJGCT NO. 106175
Revised December 8, 2023
006119-1
MAINT�NANCE BOND
Page 1 of 3
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SECTION 00 Gl 19
MAINTENANCE BOND Bond # 1os262668
THE STATE OF TEXAS §
§ KNOW ALL 13Y THESE PRESENTS:
COUNTY OF TARRANT §
That we Peachtree, Construction, Ltd.,, lcnown as "Principal" herein and
Travelers Casualty and Surety Company of America , a corporate surety (sureties, if more than
one) duly authorized to do business in the State of Texas, lcnown as "Surety" herein (whether one
or more), a�e held and firn11y bound unto the City of Fort Worth; a municipal corporation created
pursuant to the laws of the State of Texas, lcnown as "City" I�erein, in the sum of TWO
MILLION NINE HUNDRED NINETY-EIGHT THOUSAND, FIVE HUNDRED FORTY-
FOUR AND 50/100 DOLLARS (�2.998,544.501, lawful monay af the United States, to be paid
14 in Fort Worth, Tarrant County, Texas, for payment of which sum well and truly be made unto the
15 City and its successors, we bind ourselves, our heirs, executors, administrators, successors and
16 assigns, jointly and severally, firinly by these presents.
17
18 WI3EREAS, the Principal has entered into a certain written contract with the City awarded
19 the 9t�' day of December, 2025. which Contract is hereby referred to and a made part hereof for
20 all purposes as if fully set forth herein, to furnish all materials, equipment labor and other
2I accessories as defined by law, in the prosecution of the Worlc, including any Worlc resulting fi�om
22 a duly authorized Change Order {collectively herein, the "Work"} as provided For in said contract
�3 and-d�signated-as 20-26-ASPHAL-T-RE�SURF-AC-INGC-ON-T-RAC-T�,-C-ity Projeet No.-1 OF 17�;
24 and
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WHEREAS, Principal 6inds itself to use such matet�ials and to so construct the Work in
accordance with the plai�s, s�ecifications and Contract Documents that the Worlc is a�id will
remain free from defects in materials or worlananship for and during the period of two (2) years
after the date of Final Acceptance of the Worlc by the City ("Maintenance Period"); and
WHEREAS, Principal binds itself to repair or reconstruct the Worlc in whole or in part.
upon receiving notice from tl�e City of the need therefor at any time within the Maintenance
Period.
CITY OF FORT WORTH 2O2G ASPHALT R�SURPACING CONTRACT 3
STANDARD CONSTRUCTION SPECIP'SCATION DOCUIvICNTS CITY PROJECT NO. lOG175
Revised December 8, 2023
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006119-2
MAINTENANCE BOND
Page 2 of 3
NOW THEREFORE, the condition of this obligation is such that if Principal shall
remedy any defective Work, for which timely notice was provided by City, to a completion
satisfactory to the City, then tl�is obligation shall become null and void; otherwise to remain in
full Porce and effect.
PROVIDEll, HOWEVER, if Principal shall fail so to repair or reconstruct any tiinely
noticed defective Worlc, it is agreed that the City may cause any and all such defective Wock to
be i•epaired and/or reconstructed with all associated costs thereof being borne by the Principal and
the Surety under this Maintenance bond; and
PROVIDED FURTHER, that if any legal action be filed on this Bond, venue shall lie in
Tarrant County, Texas or the United States District Court for the Northern District of Texas, Fort
Worth Division; and
PROVIDED FURTHER, that this obligation shall be continuous in nature and
successive recoveries may be l�ad hereon for successive breaches.
CI"fY OF FORT WORTH
STANDARD CONSTRUCTION SP�CII'ICATION DOCUMENTS
Revised December 8, 2023
2026 ASPHALT RESURFACING CONTRACT 3
CITY PROJECT NO. 106175
0061 19-3
MAINTENANCE BOND
Page 3 of 3
�
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L�I
IN WITNESS WHEREOF, the Principal and the Surety have each SIGNED and SEALED this
instrument by duly authorized agents and officers on this the Z9th day of �ecember
. 2� 25 .
ATTEST:
(Principal) Secretary
Witne�as to Principal
ATTEST:
(Surety) Secretary
���__ ��__.
Witness as to Surety Brisa Reyes - Agent
PRINCIPAL:
Peachtree Const tion, Ltd.
BY: � � �
S�gnature
J. BARRY CLARK
PRESIDENT
Name and Title
Address: 5801 Park Vista Circle
Fort Worth, TX 76244
SURETY:
Travelers Casualty and Surety Company of America
aa, �
n
BY: % {:�'�.f''.�,/t ,� �'��: i C',
� �Signature � �
Teresa Ayala Atty-in-Fact
Name and Title
Address: 2900 Marquita Dr
Fort wortn. Tx �s �� s
Telephone Number: $»-�37-49a3
Erilall l�ddl'055: TEAvala(�Acris�re com
*Note: If signed by an officer of the Surety Company, there must be on file a certified extract
from the by-laws showing that this person has authority to sign such obligation. If
Surety's physical address is different from its mailing address, both must be provided.
The date of the bond shall not be prior to the date the Contract is awarded.
CITY OF FORT WORTH
STANDARD CONSTRUCTION SPECIFICATION DOCUMENTS
Revised December S, 2023
2026 ASPHALT RESURP'ACING CONTRACT 3
CITY PROJECT NO. 106175
TRAVELERS�
Travelers Casualty and Surety Company of America
Travelers Casualty and Surety Company
St. Paul Fire and Marine Insurance Company
POWER OF ATTORNEY
KNOW ALL MEN BY THESE PRESENTS: That Travelers Casualty and Surety Company of America, Travelers Casualty and Surety Company, and
St. Paul Fire and Marine Insurance Company are corporations duly organized under the laws of the State of Connecticut (herein
collectively called the "Companies"), and that the Companies do hereby make, constitute and appoint Teresa Ayala of
FT WORTH , Texas , their true and lawful Attorney(s)-in-Fact to sign, execute, seal and
acknowledge any and all bonds, recognizances, conditional undertakings and other writings obligatory in the nature thereof on behalf of
the Companies in their business of guaranteeing the fidelity of persons, guaranteeing the pertormance of contracts and executing or
guaranteeing bonds and undertakings required or permitted in any actions or proceedings allowed by law.
IN WITNESS WHEREOF, the Companies have caused this instrument to be signed, and their corporate seals to be hereto affixed, this 21st day of April,
2021.
.�,w,,.r
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Y p //'' .A�� ��
// ♦�
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�1 � y�� �� n i,v -`�.�
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ir.M+a'.. �:
State of Connecticut
City of Hartford ss.
�� �� �
By: ,.�'�'
Robert L. Rane , enior Vice President
On this the 21st day of April, 2021, before me personally appeared Robert L. Raney, who acknowledged himself to be the Senior
Vice President of each of the Companies, and that he, as such, being authorized so to do, executed the foregoing instrument for the
purposes therein contained by signing on behalf of said Companies by himself as a duly authorized officer.
IN WITNESS WHEREOF, I hereunto set my hand and official seal
My Commission expires the 30th day of June, 2026
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•e•,�i ` • /;�/'I✓,4•¢1 �I�����/�
' NO(J��Y h
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i f`IJP.:�IC ;
4 f t Anna P. Nowik, Notary Public
�''�t �'�•4N F� :ti : �`�F
This Power of Attorney is granted under and by the authority of the following resolutions adopted by the Boards of Directors of each of
the Companies, which resolutions are now in full force and effect, reading as follows:
RESOLVED, that the Chairman, the President, any Vice Chairman, any Executive Vice President, any Senior Vice President, any Vice
President, any Second Vice President, the Treasurer, any Assistant Treasurer, the Corporate Secretary or any Assistant Secretary may appoint
Attorneys-in-Fact and Agents to act for and on behalf of the Company and may give such appointee such authority as his or her certificate of authoriry
may prescribe to sign with the Company's name and seal with the Company's seal bonds, recognizances, contracts of indemnity, and other writings
obligatory in the nature of a bond, recognizance, or conditional undertaking, and any of said officers or the Board of Directors at any time may
remove any such appointee and revoke the power given him or her; and it is
FURTHER RESOLVED, that the Chairman, the President, any Vice Chairman, any Executive Vice President, any Senior Vice President or
any Vice President may delegate all or any part of the foregoing authority to one or more officers or employees of this Company, provided
that each such delegation is in writing and a copy thereof is filed in the office of the Secretary; and it is
FURTHER RESOLVED, that any bond, recognizance, contract of indemnity, or writing obligatory in the nature of a bond, recognizance,
or conditional undertaking shall be valid and binding upon the Company when (a) signed by the President, any Vice Chairman, any Executive
Vice President, any Senior Vice President or any Vice President, any Second Vice President, the Treasurer, any Assistant Treasurer, the
Corporate Secretary or any Assistant Secretary and duly attested and sealed with the Company's seal by a Secretary or Assistant Secretary;
or (b) duly executed (under seal, if required) by one or more Attorneys-in-Fact and Agents pursuant to the power prescribed in his or her
certificate or their certificates of authority or by one or more Company officers pursuant to a written delegation of authority; and it is
FURTHER RESOLVED, that the signature of each of the following officers: President, any Executive Vice President, any Senior Vice President,
any Vice President, any Assistant Vice President, any Secretary, any Assistant Secretary, and the seal of the Company may be affixed by facsimile to
any Power of Attorney or to any certificate relating thereto appointing Resident Vice Presidents, Resident Assistant Secretaries or Attorneys-in-
Fact for purposes only of executing and attesting bonds and undertakings and other writings obligatory in the nature thereof, and any such Power of
Attorney or certificate bearing such facsimile signature or facsimile seal shall be valid and binding upon the Company and any such power so executed
and certified by such facsimile signature and facsimile seal shall be valid and binding on the Company in the future with respect to any bond or
understanding to which it is attached.
I, Kevin E. Hughes, the undersigned, Assistant Secretary of each of the Companies, do hereby certify that the above and foregoing is a
true and correct copy of the Power of Attorney executed by said Companies, vvhicfi remains in full force and effect.
Dated this 29th day of December , 2025
, �t°t��w`�Yc �J°`tr n,yos �y.��}�qk
{�r.�`� �� ,; �b Lr,f #' �
�3 Hn!ITFOqD,111 Ti'e a� NARTFORD, < �. �ti',R?'�qiSf
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Kevin E. Hughes, Assi� retary
To verily the authenticity of this Power ofAtto�ney, p/ease ca// us at 1-800-411-3880.
P/ease refer to the above-named Attorney(s)-in-Fact and the detai/s of the bond to which this Power ofAtto�ney is attached.
IMPORTANT NOTICE
To obtain information or make a complaint:
You may call Travelers Casualty and Surety Company of America and its affiliates' toll-
free telephone number for information or to make a complaint at:
1-800-328-2189
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) 475-1771
Web: httq://www.tdi.state.tx.us
E-mail: ConsumerProtection(c�tdi.state.tx.us
PREMIUM OR CLAIM DISPUTES:
Should you have a dispute concerning your premium or about a claim you should
contact your Agent or Travelers first. If the dispute is not resolved, you may contact the
Texas Department of Insurance.
ATTACH THIS NOTICE TO YOUR BOND:
This notice is for information only and does not become a part or condition of the
attached document and is given to comply with Texas legal and regulatory requirements.
(PN-042-B) Ed.10.18.07
�RAVELERSJ�
INSURING COMPANY:
THE PHOENIX INSURANCE COMPANY
One Tower Square, HarCf�rd, Connecticut 06183
TRAVELERS CdRP. TEL: 1-800-328-2189
STREET & ROAD CONTRACTORS
COMMON POLICY DECLARATIONS
ISSUE DATE: 06/21/24
POLICY NUMBER: DT-CO-3637R894-PHX-24
1. NAMED INSURED AND MAILING ADDRESS:
PEACHTREE CONSTRUCTION, LTD
5801 PARK VISTA CIRCLE
KELLER, TX 76244
2. POLICY PERIOD: From 06/30/24 to 06/30/25 12:01 A.M, Standard Time at
your mailing address.
3. LOCATIONS
Premises Bldg.
Loc. No. No. Oecupancy Address
SEE IL TO 03
4. COVERAGE PARTS FORMING PART OF THIS POLICY AND INSURING COMPANIES:
COMMERCIAL PROPERTY COV PART DECLARATIONS CP TO 11 01 03 PHX
CONII�IERCIAL GENERAL LIABILITY COV PART DECLARATIONS CG TO 01 11 03 PHX
EMPLOYEE BENEFITS LIABILITY COV PART DECLARATiONS CG TO 09 09 93 PHX
5. NUMBERS OF FORMS AND ENDORSEMENTS
FORMTNG A PART OF THIS POLICY: SEE IL T8 01 10 93
6. SUPPLEMENTAL POLICIES: Each of the following is a separate policy
containing its complete provisions:
Policy Policy No. Insuring Company
7. PREMIUM SUI�IARY:
NAME AND ADDRESS OF AGENT OR BROKER:
FRANK SIDDONS INS AGCY (VP283)
2900 MARQUITA DR
FT WORTH, TX 76116
COUNTERSIGNED BY:
Authorized Representative
DATE:
IL TO 02 11 89(REV. 09-07) PAGE 1 OF 1
OFFICE: DALLAS
�RAVELERS J�
POLICY NUMBER: DT-CO-3637R894-PHX-24
EFFECTIVE DATE: 06-30-24
ISSUE DATE: 06-21-24
LISTING OF FORMS, ENDORSEMENTS AND SCHEDULE NUMBERS
THIS LISTING SHOWS THE NUMBER OF FORMS, SCHEDULES AND ENDORSEMENTS
BY LINE OF BUSINESS.
IL TO 02 11 89 COMMON POLICY DECLARATIONS
IL T8 01 10 93 EORMS, ENDORSEMENTS AND SCHEDULE NUMBERS
IL TO 15 01 04 POLICY JACKET-EXECUTION CLAUSE
IL TO 01 01 07 COMMON POLICY CONDITIONS
IL TO 03 04 96 LOCATION SCHEDULE
IL T8 03 GENERAL PURPOSE E�DORSEMENT
IL T3 20 05 19 NOTICE - CANC, NONRENEWAL PROVIDED BY US
COI�IERCIAL PROPERTY
CP TO
CP TO
CP 00
CP T1
CP T1
CP T3
CP T3
CP T3
CP T3
CP T3
CP T4
CP T9
11
00
90
00
08
68
69
95
38
81
52
07
Ol 03
02 11
07 88
02 17
02 17
02 17
01 23
02 17
02 17
01 21
01 23
02 17
COMQ+3ERCIAL PROPERTY DECLARATION5
TABLE OF CONTENTS CONIl�IERCIAL PROPERTY
COMMERCIAL PROPERTY CONDITIONS
BUILDING AND PERSONAL PROPERTY COVERAGE
CAUSE OF LOSS - SPECIAL FORM
FUNGUS WET ROT OR DRY ROT AND OTHER CAUS
ELECTRONIC VANDALISM LIMIT & OTHER CHANG
WINDSTORM OR HAIL PERCENTAGE DEDUCTIBLE
PROPERTY EXTRA
FEDERAL TERRORISM RISK INSURANCE ACT DIS
DIGITAL ASSETS EXCL
TEXAS CHANGES
GENERAL LIABILITY - CONTRACTORS
CG TO
CG D3
CG TO
CG TO
CG TO
CG T1
CG D6
CG D9
CG D2
CG D2
CG D3
CG D2
CG D2
CG D3
CG D5
CG D6
CG D9
CG F2
CG 21
01
05
07
08
34
00
04
10
03
11
16
43
93
22
46
18
44
68
54
11 03
07 08
09 87
11 03
02 19
02 19
02 19
09 21
12 97
01 04
02 19
01 02
11 03
10 20
10 11
10 11
01 23
02 19
12 19
COML GENERAL LIABILITY COV PART DEC
DEDUCTIBLE LIABILITY INSURANCE
DECLARATIONS PREMIUM SCHEDULE
KEY TO DECLARATIONS PREMIUM SCHEDULE
TABLE OF CONTENTS - COM GEN LIAB COV
COMMERCIAL GENERAL LIABILITY COV FORM
BLANKET ADDL INS � AUTOMATIC STATUS REQ
AMENDMENT OF INTELLECTUAL PROPERTY EXCL
AMEND-NON CUNNLATION OF EACH OCC
DESIGNATED PROJECT(S) GEN AGGR LIMIT
XTEND ENDORSEMENT FOR CONTRACTORS
FUNGI OR BACTERIA EXCLUSION
EXCL-CONSTRUCT MANAGE ERRORS & OMISSIONS
EXCL-CLMS OR SUITS BY NAMED INSUREDS
EXCL - ARCHITECT/ENG/SURVEY PROF SERV
EXCL-VIOLATION OF CONSUMER FIN PROT LAWS
EXCL-VIOLATTONOFBIOMETRICINFOPRIVACYLAWS
TX CHANGES-EMPL-RELATED PRACTICES EXCL
EXCL-DESTG OPS CVRD BY A CONTROLLED IP
IL T8 01 10 93 PAGE: 1 OF 2
TRAVELERS J�
POLICY NUMBER: DT-CO-3637R894-PHX-24
EFFECTIVE DATE: 06-30-24
ISSUE DATE: 06-21-24
GENERAL LIABILITY - CONTRACTORS (CONTINUED)
CG
CG
CG
CG
CG
CG
CG
CG
CG
CG
CG
DO
D1
D1
D2
D2
T4
01
TO
TO
T1
D9
76
42
73
04
40
81
03
09
43
01
48
06
02
02
12
09
11
06
09
01
01
01
93
19
19
17
15
88
06
93
16
16
23
INTERLINE ENDORSEMENTS
IL
IL
IL
IL
IL
IL
IL
IL
IL
IL
IL
IL
IL
'CO
T3
T4
T4
T4
T4
T4
T3
00
01
02
FO
FO
EXCLUSION-LEAD
EXCLUSION-DISCRIMINATION
AMEND-POLL EXCL-INCL LTD COV POLL COST
EXCL-EXTERIOR INSULATION & FINISH SYSTEM
EXCLUSION -SILICA OR SILICA-RELATED DUST
EXC-HAZARD-CONNECTED DESIGNATED EXPOSURE
TEXAS CHANGES
EMPLOYEE BENEFITS LIAB COV PART DEC
EMPLOYEE BENEFITS LIAB TABLE OF CONTENTS
EMPLOYEE BENEFITS LIABILITY COV FORM
EXCL-VIOLATIONOFBIOMETRICINFOPRIVACYLAWS
ACTUAL CASH VALUE
FED TERRORISM RISK INS ACT DISCLOSURE
DESIG PERSON, ORG-NOTICE PROVIDED BY US
AMNDT COMMON POLICY COND-PROHIBITED COVG
CAP ON LOSSES FROM CERT ACTS OF TERRORIS
ADDITIONAL BENEFITS
PROTECTION OF PROPERTY
EXCL OF LOSS DUE TO VIRUS OR BACTERIA
NUCLEAR ENERGY LIAB EXCL END-BROAD FORM
TEXAS CHANGES - DUTIES
TX CHNG-CANC & NONRENEW PROV-CAS LINES
EXCL OF CERTAIN COMPUTER RELATED LOSSES
EARLIER NOTICE CANCEL/NONRENEWAL-TX
63
68
05
12
14
27
40
82
21
68
75
22
25
07
01
05
03
01
06
10
05
09
03
11
08
09
22
21
19
15
21
19
20
13
08
12
13
98
98
POL2CYHOLDER NOTICES
PN T2 27 06 19 LOSS CONTROL SERVICES (TEXAS)
PN U1 93 11 21 IMPNOTIC�TX-EXCLSILICAORSILICARELTEDDUST
PN U3 53 06 19 IMPT NOTICE - FLOOD - TX
IL T8 01 10 93 PAGE: 2 OF
POLICY NUMBER: DT-CO-3637R894-PHX-24
ISSUE DATE: 0�-21-24
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
DESIGNATED PERSON OR ORGANIZATION - NOTICE OF
CANCELLATION PROVIDED BY US
This endorsement modifies insurance provided under the following:
ALL COVERAGE PARTS INCLUDED IN THIS POLICY
SCHEDULE
CANCELLATION: Number of Days Notice: 30
PERSON OR
ORGANIZATION:
ANY PERSON OR ORGANIZATION THAT IS
(CONTTNUED ON IT� T8 03)
ADDRESS:
THE ADDRES3 SHOWN FOR THAT PERSON
(CONTINUED ON IL T8 03i
KELLER
TX
7fi248
PROVISIONS
If we cancel this policy for any legally permitted reason other than nonpayment of premium, and a number of days
is shown for Cancellation in the Schedule above, we will mail notice of cancellation to the person or organization
shown in such Schedule. We will mail such notice to the address shown in the Schedule above at least the
number of days shown for Cancellation in such Schedule before the effective date of cancellation.
IL 74 05 05 19 O 2019 The Travelers Indemnity Company. All rights reserved. Page 1 of 1
POLICY NUMBER: DT-CO-3637R894-PHX-24 GENERAL PURPOSE ENDORSEMENT
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
DESIGNATED ENTITY - NOTICE OF CANCELLATION FROVIDED BY US
IL T4 05 05 19
THIS ENDORSEMENT MODIFIES INSURANCE PROVIDED UNDER THE FOLLOWING:
ALL COVERAGE PAR'TS INCLUDED .IN THIS POLICY
CONTINUATION OF FORM IL T4 05, PERSON OR ORGANIZATION:
ANY PERSON OR ORGANIZATION TO WHOM YOU HAVE AGREED IN A WRITTEN CONTRACT THAT
NOTICE OF CANCELLATION OF THIS POLICY WILL BE GIVEN, BUT ONLY IF:
1. YOU SEND US A WRTZ'TEN REQUEST TO PROVIDE SUCH NOTICE, INCLUDING THE NAME
AND ADDRESS OF SUCH PERSON OR ORGANIZATION, AFTER THE FIRST NAMED INSURED
RECEIVES NOTICE FROM US OF THE CANCELLATION OF THIS PQLICY; AND
2. WE RECETVE SUCH WRITTEN REQUEST AT LEAST 14 DAYS BEFORE THE BEGINNING OF
THE APPLICABLE NIJMBER OF DAYS SHOWN IN THIS SCHEDULE.
ADDRESS: THE ADDRESS FOR THAT PERSON OR ORGANIZATION INCLUDED IN SUCH
WRITTEN REQUEST FROM YOU TO US.
IL T8 03 Page 1
COMMERCIAL GENERAL LIABlLlTY
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
BLANKET ADDITIONAL INSURED - AUTOMATIC STATUS
!F REQUIRED BY WRITTEN CONTRACT (CONTRACTORS)
This endorsement modifies insurance provided under the following:
COMMERCIAL GENERAL LlABILITY COVERAGE PART
The following is added to SECTION 11 — WHO IS AN
IfVSURED:
Any person or organization that:
a. You agree in a written contract or agreement to
include as an additional insured on this Coverage
Part; and
b. Has not been added as an additional insured for
the same project by attachment of an endorse-
ment under this Coverage Part which includes
such person or organization in the endorsement's
schedule;
is an insured, but:
a. Only with respect to liability for "bodily injury" or
"property damage" that occurs, or for "personal
injury" caused by an offense that is committed,
subsequent to the signing of that contract or
agreement and while that part of the contract or
agreement is in effect; and
b. Only as described in Paragraph (1), (2) or (3) be-
low, whichever applies:
(1) If the written contract or agreement specifical-
ly requires you to provide additional insured
coverage to th�t person or organization by
the use of:
(a) The Additional Insured — Owners, Les-
sees or Contractors —(Form B) endorse-
ment CG 20 10 11 85; or
(b) Either or both of the fallowing: the Addi-
tional Insured — Owners, Lessees or Con-
tractors — Scheduled Person Or Organi-
zation endorsement CG 20 10 10 01, or
the Additional Insured — Owners, Lessees
or Contractors — Completed Operations
endorsement CG 20 37 10 01;
the person or organization is an additional in-
sured only if the injury or damage arises out
of "your work" to which the written contract or
agreement applies;
(2) If the written contract or agreement specifical-
ly requires you to provide additional insured
coverage to that person or organization by
the use of:
(a) The Additional Insured — Owners, Les-
sees or Contractors — Scheduled Person
or Organization endorsement CG 20 10
07 04 or CG 20 10 04 13, the Additianal
Insured — Owners, Lessees or Contrac-
tors — Completed Operations endorse-
men# CG 20 37 07 04 or CG 20 3 7 04 13,
or both of such endorsements with either
of those edition dates; or
(b) Either or both of the following: the Addi-
tional Insured — Owners, Lessees or Con-
tractors — Scheduled Person Or Organi-
zation endorsement CG 20 10, or the Ad-
ditional Insured — Owners, Lessees or
Contractors — Completed Operations en-
dorsement CG 20 37, without an edition
date of such endorsement specified;
the person or organization is an additional in-
sured only if the injury or damage is caused,
in whole or in part, by acts or omissions of
you or your subcontractor in the performance
of "your work" to which the written contract or
agreement applies; or
(3) If neither Paragraph ('I) nor (2) above applies:
(a) The person or organization is an addi-
tional insured only if, and to the extent
that, the injury or damage is caused by
acts or omissions of you or your subcan-
tractor in the performance of "your work"
to which the written contract or agree-
ment applies; and
(b) Such person or organization does not
qualify as an additional insured with re-
spect to the independent acts or omis-
sions of such person or organization .
The insurance provided to such additional insured is
subject to the following provisions:
a. If the Limits of Insurance of this Coverage Part
shown in the Declarations exceed the minimum
limits required by the written contract or agree-
ment, the insurance provided to the additional in-
sured wiil be limited to such minimum required
limits. For the purposes of determining whether
CG D6 04 02 19 O 2017 The Travelers Indemnity Company. All rights reserved. Page 1 Of 2
COMMERCIAL GENERAL LIABILITY
this limitation applies, the minimum limits required
by the written contract or agreement will be con-
sidered to include the minimum (imits of any Um-
brella or Excess liability coverage required for the
additional insured by that written contract or
agreement. This provision will not increase the
limits of insurance described in Section III — Limits
Of Insurance.
b. The insurance provided to such additional insured
does not apply to:
(1) Any "bodily injury", "property damage" or
"personal injury" arising out of the providing,
or failure to provide, any professional archi-
tectural, engineering or surveying services,
including:
(a) The preparing, approving> or failing to
prepare or approve, maps, shop draw-
ings, opinions, reports, surveys, field or- (3)
ders or change orders, ar the preparing,
approving, or failing to prepare or ap-
prove, drawings and specifications; and
(b) Supervisory, inspection, architectural or
engineerin g activities.
(2) Any "bodily injury" or "property damage"
caused by "your work" and included in the
"products-completed operations hazard" un-
less the written contract or agreement specifi-
cally requires you to provide such coverage
for that additional insured during the policy
period.
c. The additional insured must comply with the fol-
lowing duties:
(1) Give us written notice as soon as practicable
of an "occurrence" or an offense which may
result in a claim. To the extent possible, such
notice should include:
(a) How, when and where the "occurrence"
or offense took place;
(b) The names and addresses of any injured
persons and witnesses; and
(c) The nature and location of any injury or
damage arising out of the "occurrence" or
offense.
(2) If a claim is made or "suit" is brought against
the additional insured:
(a) Immediately record the specifics of the
claim or "suit" and the date received; and
(b) Notify us as soon as practicable and see
to ii that we receive written notice of the
claim or "suit" as soon as practicable.
Immedia#ely send us copies of all legal pa-
pers received in connection with the claim or
"suit", cooperate with us in the investigation
or settlement of the claim or defense against
the "suit", and otherwise comply with all policy
conditions.
(4) Tender the defense and indemnity of any
claim or "suit" to any provider of other insur-
ance which would cover such additional in-
sured for a loss we cover. However, this con-
dition does not affect whether the insurance
provided to such additional insured is primary
to other insurance available to such additional
insured which covers that person or organiza-
tion as a named insured as described in Par-
agraph 4., Other Insurance, of Section IV —
Commercial General Liability Conditions.
Page 2 of 2 O 2017 The Travelers Indemnity Company. All rights reserved. CG D6 04 02 19
COMMERCIAL GENERAL LIABILITY
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
XTEND ENDORSEMENT FOR CONTRACTORS
This endorsement modifies insurance provided under the following:
COMMERCIAL GENERAL LIABILITY COVERAGE PART
GElVERAL DESCRIPTION OF COVERAGE — This endorsement broadens coverage. However, coverage for any
injury, damage or medical expenses described in any of the provisions of this endorsement may be excluded or
limited by another endorsement to this Coverage Part, and these coverage broadening provisions do not apply to
the extent that coverage is excluded or limited by such an endorsement. The following listing is a general
coverage description only. Read all the provisions of this endorsement and the rest of your policy carefully to
determine rights, duties, and what is and is not covered.
A. Who Is An Insured — Unnamed Subsidiaries
B. Blanket Additional Insured — Governmental
Entities — Permits Or Authorizations Relating To
Operations
C. Incidental Medical Malpractice
D. Blanket Waiver Of Subrogation
E. Contractual Liability — Railroads
F. Damage To Premises Rented To You
PROVISIONS
A. WHO IS AN INSURED — UNNAMED
SUBSIDIARIES
The following is added to SECTION II — WHO IS
AN INSURED:
a. An organization other than a partnership, join#
venture or limited liability company; or
b. A trust;
as indicated in its name or the documents that
govern its structure.
Any of your subsidiaries, other than a partnership, g, gLANKET ADDITIONAL INSURED —
joint venture or limited liability company, that is GOVERNMENTAL ENTITIES — PERMITS OR
not shown as a Named Insured in the AUTHORIZA710NS RELATING TO OPERATIOfVS
Declarations is a Named Insured if:
a. You are the sole owner of, or maintain an
ownership interest of more than 50% in, such
subsidiary on the first day of the policy period;
and
b. Such subsidiary is not an insured under
similar other insurance.
No such subsidiary is an insured for "bodily injury"
or "property damage" that occurred, or "personal
and advertising injury" caused by an offense
committed:
a. Before you maintained an ownership interest
of more than 50% i n such subsidiary; or
The following is added to SECTION II — WHO lS
AN INSURED:
Any governmental entity that has issued a permit
or authorization with respect to operatians
performed by you or on your behalf and that you
are required by any ordinance, law, building code
or written contract or agreement to include as an
additional insured on this Coverage Part is an
insured, but only with respect to liabi lity for "bodily
injury", "property damage" or "personal and
advertising injury" arising out of such operations.
The insurance provided to such governmental
entity does not apply to:
b. After the date, if any, during the policy period a. Any "bodily injury", "properry damage" or
that you no longer maintain an ownership "personal and advertising injury" arising out o#
interest of more than 50% in such subsidiary. operations per�ormed for the governmental
entity; ar
For purposes of Paragraph '1. of Section II — Who
Is An Insured, each such subsidiary will be b. Any "bodily injury" or "properry damage"
deemed to be designated in the Declarations as: included in the "products-compfeted
operations hazard".
CG D3 16 02 19 oO 2017 The Travelers Indemniry Company. All rights reserved. Page 1 of 3
Includes copyrighted material of Insurance Services Office, Inc., with its permission.
COMMERCIAL GENERAL LIABILITY
C. INCIDENTAL MEDICAL MALPRACTICE
1. The following replaces Paragraph b. of the
definition of "occurrence" in the
DEFINITIONS Section:
pharmaceuticals committed by, or with the
knowledge or consent of, the insured.
5. The fallowing is added to the DEFINITIONS
Section:
b. An act or omission committed in providing
or failing to provide "incidental medical
services", first aid or "Good Samaritan
services" to a person, unless you are in
the business or occupation of, providing
professional health care services.
2. The following replaces the last paragraph of
Paragraph 2.a.(1) of SECTION II — WHO IS
AN INSURED:
Unless you are in the business or occupation
of providing professional health care services,
Paragraphs (1)(a), (b), (c) and (d) above do
not apply to "bodily injury" arising out of
providing or failing to provide:
(a) "Incidental medical services" by any of
your "employees" who is a nurse, nurse
assistant, emergency medical technician
or paramedic; or
(b) First aid or "Good Samaritan services" by
any of your "employees" or "volunteer
workers", other than an employed or
volunteer doctor, Any such "employees"
or "volunteer workers" providing or failing
to provide first aid or "Good Samaritan
services" during their work hours for you
will be deemed #o be acting within the
scope of their employment by you or
performing duties related to the conduct
of your business.
3. The following replaces the ias# sentence of
Paragraph 5. of SECTION Ilt — LIMITS OF
INSURANCE:
For the purposes of determining the
applicable Each Occurrence Limit, all related
acts or omissions committed in providing or
failing to provide "incidental medical
services", first aid or "Good Samaritan
services" to any one person will be deemed to
be one "occurrence".
"Incidental medical services" means:
a. Medical, surgical, dental, laboratory, x-ray
or nursing service or treatment, advice or
instruction, or the related furnishing of
food or beverages; or
b. The furnishing or dispensing of drugs or
medical, dental, or surgical supplies or
appliances.
6. The fallowing is added to Paragraph 4.b.,
Excess Insurance, of SECTION IV —
COMMERCIAL GENERAL LIABIL{TY
CONDETIONS:
This insurance is excess over any valid and
collectible other insurance, whether primary,
excess, contingent or on any other basis, that
is available to any of your "employees" for
"bodily injury" that arises out of providing or
failing to provide "incidental medical services"
to any person to the extent not subject to
Paragraph 2.a.(1) of Section II — Who Is An
Insured.
D. BLANKET WAIVER OF SUBROGATION
The following is added to Paragraph 8., Transfer
Of Rights Of Recovery Against Others To Us,
of SECTION IV — COMMERCIAL GENERAL
LIABILITY CONDITIONS:
If the insured has agreed in a contract or
agreement to waive that insured's right of
recovery against any person or organization, we
waive our right of recovery against such person or
organization, but only for payments we make
because of:
a. "Bodily injury" or "property damage" that
occurs;or
b. "Personal and advertising injury" caused by
an offense that is committed;
4. The following exclusion is added to subsequent to the execution of the contract or
Paragraph 2., Exclusions, of SECTION I— agreement.
COVERAGES — COVERAGE A— BODILY E. CONTRACTUAL LIABILITY — RAILROADS
INJURY AND PROPERTY DAMAGE
LIABILITY: 1. The following replaces Paragraph c. of #he
Sale Of Pharmaceuticals definitian of "insured contract" in the
"Bodily injury" or "property damage" arising DEFINITIONS Section:
out of the violation of a penal statute or c. Any easement or license agreement;
ordinance relating to the sale of
Page 2 of 3 O 2017 7he Travelers Indemnity Company. All rights reserved. CG D3 16 02 19
Includes copyrighted material of Insurance Services Office, Inc., with its permission.
COMMERCIAL GENERAL LIABILITY
2. Paragraph f.(1) of the definition of "insured
contract" in the DEFINITIONS Section is
deleted.
F. DAMAGE TO PREMISES RENTED TO YOU
The following replaces the definition of "premises
damage" in the DEFINITIONS Section:
"Premises damage" means "property damage" to:
a. Any premises while rented to you or
temporarily occupied by you with permissian
of the owner; or
b. The contents of any premises while such
premises is rented to you, if you rent such
premises for a period of seven or fewer
consecutive days.
CG D3 16 02 19 OO 2017 The Travelers Indemnity Company. All rights reserved, PBge 3 of 3
Includes copyrighted material of Insurance Services Office, Inc., with its permission.
TRAVELERS�
INSURING COMPANY:
THE TR.AVELERS INDENII�'ITY COMPANY OF CONNECTICUT
1. NAMED INSURED AND MAILING ADDRESS:
PEACIiTREE CONSTRUCTION, LTD.
5801 PARK VISTA CIRCLE
KELLER TX 76244
One Tower Square, Harcford, Cannecticut 06183
TRAVELERS CORP. TEL: 1-800-328-2189
HIGHWAY, STREET, AND BRIDGE CONSTRUCTION
COMMON POLICY DECLARATIONS
ISSUE DATE: 06/21/24
POLICY NUMBER: BA-1N743599-24-26-G
2. POLICY PERIOD: From 06/30/24 to 06/30/25 12:01 A.M. Standard Time at your mailing address.
3. LOCATIONS:
Premises
Loc. No.
Bldg.
No. Occupancy
Address
4. COVERAGE PARTS FORMING PART OF THIS POLICY AND INSURIiVG COMPANIES:
COMMERCIAL AUTOMOBILE COV PART DECLARATIONS CA TO 01 02 15 TCT
5. NUMBERS OF FORMS AND ENDORSEMENTS
FORMING A PART OF THIS POLICY: SEE IL T8 09 01 01
6. SUPPLEMENTAL POLICIES: Each ofi the following is a separate policy
containing its complete provisions:
Policy Po6cy No. Insuring Company
7. PREMIUM SUIVIMARY:
Provisional Premium $ 126, 982 . 00
Due at Inception $ 12, 817 . 00
Due at Each 1 MONTH $ 12, 685,00
NAME AND ADDRESS OF AGENT OR BROKER:
FRANK SIDDONS INS AGCY(VP283)
2900 MARQUITA DR
FT WORTH TX 76116-4016
=r, To 02 11 89 (REV. 09-07) PAGE 1 OF 2
OFFICE: DALLAS TX
COUNTERSIGNED BY:
Authorized Representative
DATE:
POLICY NUMBER: BA-1N743599-24-26-G
EFFECTIVE DATE: 06j30/2024
ISSUE DATE: 06/21/2024
LISTING OF FORMS, ENDORSEMENTS AND 5CHEDULE NUMBERS
THIS LISTING SHOWS THE I3ITMBER OF FORMS, SCHEDULES AND
8Y LINE OF BUSINESS
IL TO 02 11 89
IL T8 01 01 01
IL TO 01 01 07
COMMERCYAL AUTO
COMMON POLICY DECLARATIONS
FORMS ENDOR5EMENTS AND SCHEDULE NUMBERS
CONII�ION POLICY CONDITIONS
CA TO Ol 02 15 BA- COVERAGE PART DECS (ITEM5 1& 2)
CA TO 02 02 15 BUSINESS AUTO COVERAGE PAR'£ DECLARATIONS (ITEM 3)
CA TO 03 02 15 BUS AUTO COV PART DECLARATIONS-4&5
CA TO 31 02 15 TABLE OF CONTENTS-BUSINESS AUTO COV FORM
CA 00 01 10 13 BUSINESS AUTO COVERAGE FORM
CA O1 96 10 13 TEXAS CHANGES
CA FO 85 02 15 EARLIER NOTZCE OF CANCELLATION/NONRENEWAL PROVIDED BY
US - TEXAS
CA T4 52 02 16 SHORT TERM BIRED AUTO - ADDITIONAL INSURED AND LOSS
PAYEE
CA T4 59 02 15 AMENDMENT OF EMPLOYEE DEFINITYON
CA T4 99 02 16 BLNKT ADDL INSD-PNC W/OTHR INS-CNTRCTR
CA T3 53 02 15 BUSINESS AUTO EXTENSION E13DORSEMENT
CA FO 51 02 15 TEXAS CHANGES - CANCELLATION AND NONRENEi�VAL
CA T4 45 04 09 LOSS PAYABLE CLAUSE
INTERLINE ENDORSEMENTS
IL T4 05 05 19 DESIGNATED PERSON OR ORGAN'TZATTON - NOTICE OF
CANCELLATION PROVIDED BY US
IL T4 27 06 19 ADDITIONAL BENEFITS
IL T4 12 03 15 AMNDT CONIl�20N POLICY COND-PROHIBITED COVG
IL 00 21 09 08 NUCLEAR ENERGY LIABILITY EXCLUSION ENDORSEMENT (BROAD
FORM)
POL2CY HOLDER NOTICES
PN T2 27 06 19
LOSS CONTROL SERVICES (TEXAS)
IL T8 01 01 0'1 PAGE: 1 OF 1
COMMERCIAL AUTO
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
LOSS PAYABLE CLAUSE
This endorsement modifies insurance provided under the following:
BUSINESS AUTO COVERAGE FORM
The following replaces the LOSS PAYABLE
CLAUSE in the BUSINESS AUTO COVERAGE
PART DECLARATIONS: LOSS PAYABLE CLAUSE
A. We will pay you and the loss payee on file with us
for "loss" to a covered "auto", as interest may ap-
pear.
B. The insurance covers the interest of the loss
payee unless the "loss" results fram conversion,
secretion or embezzlement on your part.
C. We may cancel the policy as allowed by the
CANCELLATION Common Policy Condition.
Cancellation ends this agreement as to the loss
payee's interest. If we cancel the policy we will
mail you and the loss payee the same advance
notice.
D. If we make any payment to the loss payee, we
will obtain their rights against any other party.
CA T4 45 04 09 O 2009 The Travelers Companies, Inc. Page 1 of 1
Includes the copyrighfed material of Insurance Services Office, Inc. with its permisslon.
POLICY NUMBER: BA-1N743599-24-26-G
ISSUE DATE: 06-21-24
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
DESIGNATED PERSON OR ORGANIZATION - NOTICE OF
CANCELLATION PROVIDED BY US
This endorsement modifies insurance provided under the following;
ALL COVERAGE PARTS INCLUDED IN THIS POLICY
SCHEDULE
CANCELLATION: IVumber of Days Notice: 30
PERSON OR
ORGANIZATION: �Y PERSON OR ORGANIZATION TO T�1HOM YOU
HAVE AGREED IN A WRITTEN CONTRACT THAT
NOTICE OF CANCELLATION OF THIS POLICY
WILL BE GIVEN, SUT ONLY IF:
1. YOU SEND US A WRITTEN REQUEST TO
PROVIDE 5UCH NOTICE, INCLUDING THE
NAME AND ADDRESS OF SUCH PERSON OR
ORGANIZATIdN, AFTER THE FIRST NAMED
INSURED RECEIVE5 NOTICE FROM US OF
THE CANCELLA'I'ION OF TH25 POLICY; AND
2. WE RECEIVE SUCH WRITTEN REQUEST AT
LEAST 14 DAYS BEFORE THE BEGINNING OF
THE APPLICABLE NUMBER OF DAYS SHOWN
IN THIS SCHEDULE.
ADDRESS:
THE ADDRESS FOR THAT PERSON OR ORGANIZ-
ATION INCLUDED IN SUCH WRITTEN REQUEST
FROM YOU TO US.
PROVISIONS
If we cancel this policy for any legally permitted reason other than nonpayment of premium, and a number of days
is shown for Cancellation in the Schedule above, we will mail notice of cancellation to the person or organization
shown in such Schedule. We will mail such notice to the address shown in the Schedule above at least the
number of days shown for Cancellation in such Schedule before the effective date of cancellation.
IL 34 05 05 79 OO 2019 The Travelers Indemnity Company. All rights reserved. Pag2 1 Of 1
COMMERCIAL AUTO
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
BLAtVKET ADDITIOIVAL INSURED - PRIMARY AND
NON-CONTRIBUTORY WITH OTHER INSURANCE -
CONTRACTORS
This endorsement modifies insurance provided under the following:
BUSINESS AUTO COVERAGE FORM
PROVISIONS
'I. The following is added to Paragraph c. in A.1.,
Who Is An Insured, of SECTION li — COVERED
AUTOS LIABILITY COVERAGE:
This includes any person or organization who you
are required under a written contract or
agreement, that is signed by you before the
"bodily injury" or "property damage" occurs and
that is in effect during the policy period, to name
as an additional insurecl for Covered Autos
Liability Coverage, but only for damages to which
this insurance applies and only to the extent of
that person's or organization's liability for the
conduct of another "insured".
2. The following is added to Paragraph B.S., Other
Insurance of SECTION IV — BUSINESS AUTO
CONDITIONS:
Regardless of the provisions of paragraph a, and
paragraph d. of this part 5. Other Insurance, this
insurance is primary to and non-contributory with
applicable other insurance under which an
additional insured person or organization is a
named insured when a written contract or
agreement with you, that is signed by you before
the "bodily injury" or "property damage" occurs
and that is in effect during the policy period,
requires this insurance to be primary and nan-
contributory.
CA T4 99 02 16 O 2016 The Travelers Indemnity Company. All rights reserved. Page 1 of 1
Includes copyrighted material of Insurance Services Office, Inc. with its permission.
COMMERCIAL AUTO
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
BUSINESS AUTO EXTENSION ENDORSEMENT
This endorsement modifies insurance provided under the following:
BUSINESS AUTO COVERAGE FORM
GENERAL DESCRIPTION OF COVERAGE — This endorsement broadens coverage. However, coverage for any
injury, damage or medical expenses described in any of the provisions of this endorsement may be excluded or
limited by another endorsement to the Coverage Part, and these coverage broadening provisions do not apply to
the extent that coverage is excluded or limited by such an endorsement. The following listing is a general cover-
age description only. Limitations and exclusions may apply to these coverages. Read all the provisions of this en-
dorsement and the rest of your policy carefully to determine rights, duties, and what is and is not covered.
A. BROAD FORM NAMED INSURED
B. BLANKET ADDITIONAL INSUREQ
C. EMPLOYEE HIRED AUTO
D. EMPLOYEES AS INSURED
E. SUPPLEMENTARY PAYMENTS — 1NCREASED
LIMITS
F. HIRED AUTO — LIMITED WORLDWIDE COV-
ERAGE — INDEMNITY BASIS
G. WAIVER OF DEDUCTIBLE — GLASS
H. HIRED AUTO PHYSICAL DAMAGE — LOSS OF
USE — WCREASED LIMIT
I. PHYSICAE. DAMAGE — TRANSPORTATION
EXPENSES —1NCREASED LIMIT
J. PERSONAL PROPERTY
K. AIRBAGS
L. NOTICE AND KNOWLEDGE OF ACCIDENT OR
LOSS
M. BLANKET WAIVER OF SUBROGATION
N. UNINTENTIONAL ERRORS OR OMISSIONS
PROVISIONS
A. �ROAD FORM NAMED INSURED
The following is added to Paragraph A.'1., Who Is
An Insured, of SECTION II — COVERED AUTOS
LIABILITY COVERAGE:
Any organization you newly acquire or form dur-
ing the policy period over which you maintain
50% or more ownership interest and that is not
separately insured for Business Auto Coverage.
Coverage under this provision is afforded only un-
til the 180th day af#er you acquire or form the or-
ganization or the end of the policy period, which-
ever is earlier.
B. BLANKET ADDITIONAL INSURED
The following is added to Paragraph c. in A.1.,
Who Is An Insured, of SECTION II — COVERED
AUTOS LIABILITY COVERAGE:
Any person or organization who is required under
a written contract or agreement between you and
that person or organization, that is signed and
executed by you before the "badily injury" or
"property damage" occurs and that is in effect
during the policy period, to be named as an addi-
tional insured is an "insured" for Covered Autos
Liability Coverage, but only for damages to which
this insurance applies and only to the extent that
person or organization qualifies as an "insured"
under the Who Is An Insured provision contained
in Section tl.
G EMPLOYEE HIRED AUTO
1. The fallowing is added to Paragraph A.9.,
Who Is An Insured, of SECTION II — COV-
ERED AUTOS LIABILITY COVERAGE:
An "employee" of yours is an "insured" while
operating an "auto" hired or rented under a
contract or agreement in an "employee's"
name, with your permission, while perForming
duties related to the conduct of your busi-
ness.
2. The following replaces Paragraph b. in B.S.,
Other Insurance, of SECTION IV — BUSI-
NESS AUTO CONDITIONS:
b. For Hired Auto Physical Damage Cover-
age, the following are deemed to be cov-
ered "autos" you own:
(1} Any covered "auto" you lease, hire,
rent or borrow; and
(2) Any covered "auto" hired or rented by
your "employee" under a contract in
an "employee's" name, with your
CA T3 53 02 15 O 2015 The Travelers Indemnity Company. All rights reserved. Page 1 Of 4
Includes copyrighted material of Insurance Servlces Offlce, Inc. with its permission.
COMMERCIAL AUTO
permissian, while performing duties
related to the conduct of your busi-
ness.
However, any "auto" that is leased, hired,
rented or borrowed with a driver is not a
covered "auto",
D. EIVIPLOYEES AS INSURED
The following is added to Paragraph A.1., Who Is
An Insured, of SECTION II — COVERED AUTOS
LIABILITY COVERAGE:
Any "employee" of yours is an "insured" while us-
ing a covered "auto" you don't own, hire or borrow
in your business or your personal affairs,
E. SUPPLEMENTARY PAYMENTS — INCREASED
LIMITS
1. The following replaces Paragraph A.2.a.(2),
of SECTION II — COVERED AUTOS LIABIL-
ITY COVERAGE:
(2) Up to $3,000 for cost of bail bonds (in-
cluding bonds for related traffic law viola-
tions) required because of an "accident"
we cover. We do not have to furnish
these bonds.
2. The following replaces Paragraph A.2.a.(4),
of SECTION II — COVERED AUTOS LIABIL-
ITY COVERAGE:
(4) All reasonable expenses incurred by the
"insured" at our request, including actual
loss of earnings up to $500 a day be-
cause of time off from work.
F. HIRED AUTO — LIMITED WORLDWIDE COV-
ERAGE — INDEMNITY BASIS
The following replaces Subparagraph (5) in Para-
graph B.7., Policy Period, Coverage Territory,
of SECTION IV — BUSINESS AUTO CONDI-
TIONS:
(5) Anywhere in the world, except any country or
jurisdiction while any trade sanction, em-
bargo, or similar regulation imposed by the
United States of America applies to and pro-
hibits the transaction of business with or
within such country or jurisdiction, for Cov-
ered Autos Liability Coverage for any covered
"auto" that you lease, hire, rent or borrow
without a driver for a period of 30 days or less
and that is not an "auto" you lease, hire, rent
or borrow from any of your "employees",
partners (if you are a partnership), members
(if you are a limited liability company) or
members of their households.
(a) With respect to any claim made or "suit"
brought outside the United States of
America, the territories and possessions
of the United States of America, Puerto
Rico and Canada:
(i) You must arrange to defend the "in-
sured" against, and investigate or set-
tle any such claim or "suit" and keep
us advised of all proceedings and ac-
tions.
(ii) Neither you nor any other involved
"insured" will make any settlement
without our consent.
(iii} We may, at our discretion, participate
in defending the "insured" against, or
in the settlement of, any claim or
"suit".
(iv} We will reimburse the "insured" for
sums that the "insured" legally must
pay as damages because of "bodily
injury" or "property damage" to which
this insurance applies, that the "in-
sured" pays with our consent, but
only up to the limit described in Para-
graph C., Limits Of Insurance, of
SECTION II — COVERED AUTOS
LIABILITY COVERAGE.
(v) We will reimburse the "insured" for
the reasonable expenses incurred
with our consent for your investiga-
tion of such claims and your defense
of the "insured" against any such
"suit", but only up to and included
within the limit described in Para-
graph C., Limits Of Insurance, of
SECTION II — COVERED AUTOS
LIABILITY COVERAGE, and not in
addition to such limit. Our duty to
make such payments ends when we
have used up the applicable limit of
insurance in payments for damages,
settlements or defense expenses.
(b) This insurance is excess over any valid
and collectible other insurance available
to the "insured" whether primary, excess,
contingent or on any other basis.
(c) This insurance is not a substitute for re-
quired or compulsory insurance in any
country outside the United States, its ter-
ritories and possessions, Puerto Rica and
Canada.
Pag2 2 Of 4 O 2015 The Travelers Indemnity Company. All rights reserved. CA T3 53 02 15
Includes copyrighted material of Insurance Services Office, Inc. wifh its permission.
COMMERCIAL AUTO
You agree to maintain all required or
compulsory insurance in any such coun-
try up to the minimum limits required by
local law, Your failure to comply with
compulsory insurance requirements will
not invalidate the coverage afForded by
this policy, but we will only be liable to the
same extent we would have been liable
had you complied with the compulsory in-
surance requirements.
(d) It is understood that we are not an admit-
ted or authorized insurer outside the
United States of America, its territories
and possessions, Puerto Rico and Can-
ada. We assume no responsibility for the
furnishing of certificates of insurance, or
for compliance in any way with the laws
of other countries relating to insurance.
G. WAIVER OF DEDUCTIBLE — GLASS
The following is added to Paragraph D., Deducti-
ble, of SECTION III — PHYSICAL DAMAGE
COVERAGE:
iVo deductible for a covered "auto" will apply to
glass damage if the glass is repaired rather than
replaced.
H. HIRED AUTO PHYSICAL DAMAGE — LOSS OF
USE — INCREASED LIMIT
The following replaces the last sentence of Para-
graph A.4.b., Loss Of Use Expenses, of SEC-
TION III — PHYSICAL DAMAGE COVERAGE:
However, the most we will pay far any expenses
for loss of use is $65 per day, to a maximum of
$750 for any one "accident".
I. PHYSICAL DAMAGE — TRANSPORTATION
EXPENSES — INCREASED LIMIT
The following replaces the first sentence in Para-
graph A.4.a., Transportation Expenses, of
SECTION III — PHYSICAL DAMAGE COVER-
AGE:
We will pay up to $50 per day to a maximum of
$1,500 for temporary transportation expense in-
curred by you because of the total theft of a cov-
ered "auto" of the private passenger type.
J. PERSONAL PROPERTY
(2) In or on your covered "auto".
This coverage applies only in the event of a total
theft of your covered "auto".
No deductibles apply to this Personal Property
coverage.
K. AIRBAGS
The following is added to Paragraph B.3., Exclu-
sions, of SECTION III — PHYSICAL DAMAGE
COVERAGE:
Exclusion 3.a. does not apply to "loss" to one or
more airbags in a covered "auto" you own that in-
flate due to a cause other than a cause of "loss"
set forth in Paragraphs A.1.b. and A.1.c., but
only:
a. If that "auto" is a covered "auto" for Compre-
hensive Coverage under this policy;
b. The airbags are not covered under any war-
ranty; and
c. The airbags were not intentionally inflated.
We will pay up to a maximum of $1,000 for any
one "Ioss".
L. NOTICE AND KNOWLEDGE OF ACCIDENT OR
LOSS
The following is added to Paragraph A.2.a., of
SECTION IV — BUSINESS AUTO CONDITIOIVS:
Your duty to, give us or our authorized representa-
tive prompt notice of the "accident" or "loss" ap-
plies only when the "accident" or "loss" is knawn
to:
(a) You (if you are an individual);
(b) A partner (if you are a partnership);
(c) A member (if you are a limited liability com-
pany};
(d) An executive officer, director or insurance
manager (if you are a corporation or other or-
ganization); or
(e) Any "employee" authorized by you to give no-
tice of the "accident" or "loss".
M. BLANKET WAIVER OF SUBROGATION
The following replaces Paragraph A.S., Transfer
Of Rights Of Recovery Against Others To Us,
of SECTION IV — BUSINESS AUTO CONDI-
TIONS :
The following is added to Paragraph A.4., Cover- 5. Transfer Of Rights Of Recovery Against
age Extensions, of SECTION III — PHYSICAL Others To Us
DAMAGE COVERAGE: We waive any right of recovery we may have
Personal Property against any person or organization to the ex-
tent required of you by a written contrac#
We will pay up to $400 for "loss" to wearing ap- signed and executed prior to any "accident"
parel and other personal property which is: or "loss", provided that the "accident" or "lass"
{1) Owned by an "insured"; and arises out of operations contemplated by
CA T3 53 02 15 O 2015 The Travelers Indemnity Company. All rights reserved. Page 3 Of 4
Includes copyrighted material of Insurance Servlces Office, Inc. with its permission.
COMMERCIAL AUTO
such contract. The waiver applies only to the The unintentional omission of, or unintentional
person or organization designated in such error in, any information given by you shall not
contract. prejudice yaur rights under this insurance. How-
N. UNINTENTIONAL ERRORS OR OMISSIONS ever this provision does not affect our right to col-
The following is added to Paragraph B.2., Con- lect additional premium or exercise our right of
cealment, Misrepresentation, Or Fraud, of cancellatian or non-renewal.
SECTION IV — BUSINESS AUTO CONDITIONS:
Page 4 of 4 O 2015 The Travelers Indemnity Compa ny. All rights reserved . CA T3 53 02 15
Includes copyrighted material of Insurance Services Office, Inc. with its permission.
%.�
0
.� X t�.a
u
WpRKERS' COMPENSATION INSURANCE
Workers' Compensation and Employer's Liability Policy
NCCI Carrier Code, 29939
Item 1 peachtree Construction, Ltd.
Insured 5801 PARK VISTA CIR
name and FORT WORTH TX 76244-5629
address
Other workplaces not shown above
See Schedule oP Operatlons attached.
Information Page
Insured copy
Policy number
0002112419
Federal tax ID � Entity
752654560 Corporation
Interim adjustment Bureau no.
Monthly 15% - 11 Reports 420628137
Producer Acrisure Texas Risk Advisors & Insurance Services LLC
5�115 5057 Keller Springs Rd Branch Safety Group
STE 200 Austin TEXAS CONSTRUCTION
Addison TX 75001-5984 SAFETY GROUP
Certificate of Approval
016-009
Item z The policy period Is from: 6/30/24 To: 6/30/25 12:01 a.m. standard time at the insured's mailing address
Item 3 A. Workers' Compensation Insurance: Part One of the policy applies to the Workers" Compensation Law of the states listed here: Texas
B. Employers Liability Insurance: Part Two of the policy applies to work in each state listed in item 3A.
The Limits of our Liability under Part Two are:
Bodily Injury by Accident $1,000,000.00 Each Accident
Bodily Injury by Disease $1,000,000.00 Policy Limit
Bodily Injury by Disease $1,000,000.00 Each Employee
C. Other States Insurance: Part Three of the policy applies to the states, if any, Ilsted here: None
D. This policy includes these endorsements and schedules; see Schedule of Endorsements attached.
Item 4
The premlum for this policy will be determined by our manuals of Rules, Classifications, Rates and Rating Plans.
All information required below is subject to verification and change by audit.
Payroll Premium
Total payroll and estimated manual premium
Description
Waiver of Subrogation
Increased Limits Factor 1,000,000/1,d00,000/1,000,000
Experience Modifier
5chedule Modifier
Healthcare Network Option
Premium Discount
Expense Constant
Factor
0,014
0.800
0.120
0.124
Total estimated annual premium
Minimum premium
Issue date: 6/19/24
Countersigned by
Includes copyright materlal of the National Councll an Compensatlon Insurance, Inc, used with its permission
OCopyright 2024 National Council of Compensatlon Insurance, Inc. All rights reserved.
Amount
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PO Box 12058, Austin, TX 78711-2058
1 of 1 texasmutual.com �(800) 859-5995 � Fax (800) 359-0650 WC 00 00 01 B
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WORKERS' COMPENSATION INSURANCE
Workers' Compensation and Employer's Liability Policy
Policy number Issue date Paficy perlod
0002112419 6/19/24 6l30/24 to 6/30/25
State Endorsemenfi
42 TM LRC 2008
42 TM MV 2011
42 TM PC 2003
42 WC OO OO OO C
42 WC 00 00 01 B
42 WC 00 04 06
42 WC 00 04 14 A
42 WC 00 04 22 C
42 WC 00 04 25
42 WC 42 03 01 L
42 WC 42 03 04 B
42 WC 42 03 08
42 WC420404A
42 WC 42 04 08 A
42 WC420601
Extension of Information Page
Item 3: Endorsement Schedule
Insured copy
Descripfiion
Limited Reimbursement for Texas Employees Injured in Other Jurisdictions
Mutuals - Membership and Voting Notice
Policy Conditions Endorsement
Policy Conditions Form
Policy Coverage Document (Declarations Page)
Premium Discount Endorsement
Notification of Change in Ownership Endorsement
Terrorism Risk Insurance Act Coverage Endorsement
Experience Rating Modification Factor Revision Endorsement
Texas Amendatory Endorsement
Blanket Texas Waiver of Our Right To Recover from Others Endorsement
Partners, Officers and Others Exclusion Endorsement
Group Purchase of Workers' Compensation Insurance Endorsement
Network Discount Endorsement
Blanket Texas Notice of Material Change Endorsement
This endorsement changes the policy to which it is attached effective on the inception date of the policy uniess a different date is indicated below.
(The following "attaching clause" need be completed only when this endorsement (s issued subsequent to preparation of the policy.)
This endorsement, effective on 6/30/24 at 12:01 a.m. standard time, forms a part of:
Policy no. 0002112419 of Texas Mutual Insurance Company effective on 6/30/24
Issued to: Peachtree Construction, Ltd.
NCCI Carrier Code: 29939
This is not a bill
�I'�+v�.✓�
Authorized representative
6/19l24
PO Box 12058, Austin, TX 78711-2058
1 of 1 texasmutual.com �(800) 859-5995 � Fax (800) 359-0650 WC 00 00 01 B-ENDS
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WORKERS' COMPENSATION INSURANCE
WORKERS' COMPENSATION AND WC 42 03 04 B
EMPLOYERS LIABILITY POLICY Insured copy
TEXAS WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT
This endorsement applies only to the insurance provided by the policy because Texas is shown in item 3.A. of the
Information Page.
We have the right to recover our payments from anyone liable for an inJury covered by this policy. We will not enforce our
right against the person or organization named in the Schedule, but this waiver applies only with respect to bodily injury
arising out of the operations described in the schedule where you are required by a written contract to obtain this waiver
from us,
This endorsement shall not operate directly or indirectly to benefit anyone not named in the Schedule.
The premium for this endorsement is shown in the Schedule.
Schedule
1. ( ) Specific Waiver
Name of person or organization
(X)Blanket Waiver
Any person or organization for whom the Named Insured has agreed by written contract to furnish this waiver.
2. Operations: All Texas operations
3. Premium:
The premium charge for this endorsement shall be 2.00 percent of the premium developed on payroll in connection
with work performed for the above person(s) or organization(s) arising out of the operations described.
4. Advance Premium: Included, see Information Page
This endorsement changes the policy to which it is attached effective on the inception date of the policy unless a different date is indicated below.
(The following "attaching clause" need be completed only when this endorsement is issued subsequent to preparation of the policy.)
This endorsement, ef#ective on 6/30/24 at 12:01 a.m. standard time, forms a part of:
Policy no. 0002112419 of Texas Mutual Insurance Company effective on 6/30/24
Issued to: Peachtree Construction, Ltd.
NCCI Carrier Code: 29939
1 of 1
This is not a bill
PO Box 12058, Austin, TX 78711-2058
texasmutual.com �(800) 859-5995 � Fax (800) 359-Q650
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Authorized representative
6/19/24
WC 42 03 04 B
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WORI<ERS' COMPENSATION INSURANCE
WORKERS' COMPENSATION AND WC 42 06 01
EMPLOYERS LIABILITY POLICY Insured copy
TEXAS NOTICE OF MATERIAL CHANGE ENDORSEMENT
This endorsement applies only to the insurance provided by the policy because Texas is shown in Item 3.A. of the
Information Page.
In the event of cancellation or other materiai change of the policy, we will mail advance notice to the person or
organization named in the Schedule. The number of days advance notice is shown in the Schedule.
This endorsement shall not operate directly or indirectly to benefit anyone not named in the Schedule.
Schedule
1, Number of days advance notice:
2. Notice will be mailed to:
�
PER LIST ON FILE
This endorsement changes the policy to which it is attached effective on the inception date of the policy unless a different date is indicated below.
(The following "attaching clause" need be completed only when this endorsement is issued subsequent to preparation of the policy.)
This endorsemeni, effective on 6/30/24 at 12:01 a.m. standard time, forms a part of:
Policy no. 0002112419 of Texas Mutual Insurance Company effective on 6/30/24
Issued to: Peachtree Construction, Ltd.
NCCI Carrier Code: 29939
This is not a bill
PO Box 12058, Austin, TX 78711-2058
1 of 1 texasmutual.com �(800) 859-5995 � Fax (800) 359-0650
��! 'm<` � '�
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Authorized representative
6/19/24
WC420601
Flores, Sophia
From: Carmichael, Robbie <RCARMICH@travelers.com>
Sent: Wednesday, January 7, 2026 9:39 AM
To: Flores, Sophia
Subject: FW: Verification of Bond#108262668
This message is from an external organization.
This message came from outside your organization.
Good Morning Sophia,
Report Suspicious
This bond is valid. Please feel free to reach out to me directly on anything Peachtree related going forward!
I�,o66ie CarinicFiaeC, �V[�A
Account E.�ecutive Officer
TRAVELERS — Bond and Specialty Insurance
9601 McAllister Freeway, Suite 700
San Antonio, TX 78216
1-210-525-3960 (Direct Line)
1-210-452-6489 Cell
���
TRAVELERSJ
�a����
From: Flores, Sophia <Sophia.Flores2�fortworthtexas.�ov>
Sent: Tuesday, January 6, 2026 4:09 PM
To: Bond POA Verify <BondPOAVerifvCa�travelers.com>
Cc: Fields, Nicholas S <Nicholas.Fields(�fortworthtexas.�ov>
Subject: [External] Verification of Bond#108262668
CAUTION: This email came from outside of the company.
Please exercise caution when opening attachments, clicking links or responding to this
email. The original sender of this email is Sophia.Flores2(a�fortworthtexas.gov.
Hello,
The City of Fort Worth requires bond verification before a contract can be executed. We have received
the following bonds from Peachtree Construction, Ltd.: Bond #180262668, in the amount of
$2,998,544.50, issued byTravelers Casualty and Surety Company of America for City Project #106175,
2026 Asphalt Resurfacing Contract 3. Please confirm that the bonds and corresponding amounts are
valid so we can proceed with awarding the contract to Peachtree Construction, Ltd. If this is not the right
bond verification address, please provide for Travelers Casualty and Surety Company of America.
1
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3
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5
6
SFC'1`ION 0{l 51 14
PAYA'[ENT 13D�1[.] gond # ro8267sss
7'iI� STA'f� C11� Tl;XAS §
� KNOW ALL 13Y 'f[[1��51� i'TtES�iVTS:
COTIl��TY O1� TAHRA�IT §
7 Chat �ti�e, i'eaclitree, Consu•uction, I.id.. ki�own �s "1'rinei�al" hcrein, �nd
� �ra�elers Casuafty and Suretyr Company of America ,� ��,rp„r�te ,ure�y
9 (sur�[ias}, duly aull�ori7ed to do bnsincss in tlic Stale oP �'�xav, knnwn as "Surcty" hcrcin
1f1 (whefhcr onc or mor�), are held and fii7nly hound u��tn il�e Cily aF C'or[ Warth, � municipal
11 �or�oratian c��eated ptusu�nt to lhe laws nF [k�e Si�te c�f'I'exss, itihawn as "Cit;�" herein. in t}�e
]2 p�nal su�n af 'I'V4'D 1VIII�l�I01\ 11INF: i;[]R"171iEIl NIIIETY-EIGIIT T11dU�5AlVil. rtr�r�
13 HU:VDR�A 1�URT'Y-i�'C][Jlt An�l 5f}l10f1 D(}LLARS fQ2,498.544.5f]]„ lawlful mnney v{' ihe
14 United States, �n he paici in ]�or� W'orlki, '1'a�•rai�t CounLy, 'i'exAs, fo�� Yl�c �ayment �F whieh sum
15 �ve13 ;3nd [riilv Uc inade, wc 6ind oiirse[�es, ��ir Itieirs, exccutars, administralars, succcssors �aiid
16 �ssigns, juintly and se�crally, firml�• Uy fhese pre�enis;
]7 WII.EI2EAS, Yri��cipal has ente��d i�ttc� u certain writte�i Contract w°ith City, a�j�az•dcd tize
18 9'!` day of I7ecember. 2f125. which Co�ttracl is hercby i�ic�•rcd lo and m��de u�s�M hereai' Par a[1
]9 purpvszs as if fu] ly set I'arLlt herein, to furnish al] materials, equip�nenL, lab�r aisd olhcr
20 accessc�ries as defined by law, in tl�e prnse�utinn of the Worlc fls pro�id�d for iii s�iid C:c�nirficl rinc!
21 desi�ated as 20�G ASPI•lAf �[' RFS�,-I�FACING CON'C'RJICT 3; City Yroject Nn, Il1C 175.
Thank you,
FORT WORTHo
Sophia Flores
Contract Compliance Specialist
Transportation & Public Works
Office 817-392-2026
100 Fort Worth Trail, Fort Worth, TX 76102
CONNECT WITH US. O 0 O�' O
This message (including any attachments) may contain confidential, proprietary, privileged and/or private information. The information is intended to be for the use
of the individual or entity designated above. If you are not the intended recipient of this message, please notify the sender immediately, and delete the message
and any attachments. Any disclosure, reproduction, distribution or other use of this message or any attachments by an individual or entity other than the intended
recipient is prohibited.
2
F�RT ��RTH�
City Secretary's Office
Contract Routing & Transmittal Slip
COntraCt01''S Name: Peachtree Construction, Ltd.
Subj ect of the Agreement: Authorize execution of a contract with Peachtree Construction, Ltd., in the amount of
$2,998,554.50 for the 2026 Asphalt Resurfacing Contract 3 Project at Various Locations (City Project No. 106175)
M&C Approved by the Council? * Yes 8 No ❑
If so, the M&C must be attached to the contNact.
Is this an Amendment to an Existing contract? Yes ❑ No 0
If so, provide the original contract nuinber and the amend�nent nuniber.
Is the Contract "PermanenY'? *Yes 8 No ❑
If unsu�e, see back page for per�nar�ent contract listing.
Is this entire contract Confidential? *Yes ❑ No 0 tfonly specific information is
Confidential, please list what information is Confidential and the page it is located.
Effective Date: 12/09/2025 Expiration Date: 12/09/2030
If diffe�er�t fror�n the approval date. If applicable.
Is a 1295 Form required? * Yes 0 No ❑
�If so, please ensure it is attached to the app�oving M&C or attached to the cont�act.
Proj ect Number: If applicable. 106175
*Did you include a Text field on the contract to add the City Secretary Contract (CSC)
number? Yes 0 No ❑
Contracts need to be routed for CSO processin� in the followin� order:
1. Katherine Cenicola (Approver)
2. Jannette S. Goodall (Signer)
3. Allison Tidwell (Form Filler)
*Indicates the information is required and if the information is not provided, the contract will be
�eturned to the department.
Permanent Contracts
Advanced Funding Agreements
Architect Service
Community Facilities
Completion Agreement
Construction Agreement
Credit Agreement/ Impact Fees
Crossing Agreement
Design Procurement
Development Agreement
Drainage Improvements
Economic Development
Engineering Services
Escrow Agreement
Interlocal Agreements
Lake Worth Sale
Maintenance Agreement/Storm Water
Parks/Improvement
Parks/Other Amenities
Parks/Play Equipment
Project Development
Property/Purchase (Property owned by the City)
Property/Sales (Property owned by the City)
Property/Transfers (Property owned by the City)
Public Art
Sanitary Sewer Main Replacements
Sanitary Sewer Rehabilitations
Settlements (Employees Only)
Streets/Maintenance
Streets/Redevelopment
Streets/Repairs
Streets/Traffic Signals
Structural Demolition (City owned properties)
Utility Relocation
Water Reclamation Facility
Water/Emergency Repair
Water/Interceptor
Water/Main Repairs
Water/Main Replacement
Water/Sanitary Sewer Rehabilitation
Water/Sewer Service
Water/Storage Tank
F�RT�ORTH�
Routing and Transmittal Slip
Transportation & Public Works
Department
DOCUMENT TITLE: 106175_2026 ASPHALT RESURFACING CONTRACT 3
M&C: 25-1139
Date: O1/08/2026
To: Name
1. Sophia Flores
2. Zelalem Arega
3. Donnette Murphy
4. Patricia Wadsack
CPN: 106175 CSO:
Department
TPW - Review
TPW-Approver
Risk-Approver
TPW-Approver
Initials
�`
Z:�
bM
PL1N'
DOC#:
Date Out
oi/os/2o2s
O1/08/2026
O1/08/2026
o1/oa/2o2s
5. Lauren Prieur TPW — Signer �o'— O1/09/2026
6. Douglas Black Legal-Signer ,,�,,,,—k O1/09/2026
7. Jesica McEachern ACM-Signer � O1/22/2026
$. Katherine Cenicola CSCO-Approver ��� O1/22/2026
9. Jannette Goodall CSCO-Signer ��, O1/23/2026
10. Allison Tidwell CSCO-Form Filler ..% O1/26/2026
11. TPW Contracts TPW
DOCUMENTS FOR CITY MANAGER'S SIGNATURE: All documents received from any
and all City Departments requesting City Manager's signature for approval MUST BE ROUTED
TO THE APPROPRIATE ACM for approval first. Once the ACM has signed the routing slip,
David will review and take the next steps.
NEEDS TO BE NOTARIZED: ❑YES �No
RUSH: ❑YES �No SAME DAY: ❑YES ❑No
ROUTING TO CSO: �YES ❑No
Action Required:
❑ As Requested
❑ For Your Information
� Signature/Routing and or Recording
❑ Comment
❑ File
NEXT DAY: ❑YES ❑No
❑ Attach Signature, Initial and Notary Tabs
Return to: Please notify TPWContract(a�fortworthtexas.�ov. Thank you!