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Home My WebLink About061955-FP1 - Construction-Related - Contract - Jackson Construction, Ltd.NN Coded 01.21.26 Department FW060-Non-PO Supplier ID: 0000008063 Supplier Name: Jackson Construction LTD Remit Address: 5112 Sun Valley Dr., Fort Worth TX 76119 Invoice No. 61955-FP1 �� RT �VO RT H Invoice Date: ##/##/#### FID 56019-2060000-103414-RETAIN �-@- �� Amount: $128,140.10 WATER DEPARTMENT NOTICE OF PROJECT COMPLETION csc rr�. 61955-FPi Regarding cont�act 61955 Walnut Creek Sanitary Sewer Ph 2 as requued by die Water Department as approved b3� City Council on 8/43/24 through M&C 24-0682 the Assistant Duector of the Water Department, upon the recommendation of die Engineering Mana�er, Water Engineering and Fiscal Services Division, has accepted the project as complete. Original Contract Prices: Amount of Approved Change Orders: Revised Contract Amount: Total Cost Worlc Completed: Less Deductions: Liyuidated Damages: Other Deductions (see comments): Total Deduction Amount: Total Cost of Work Completed: Less Previous Payments: Final Payment Due: l `�� U v �ti Recomrn�ended for Acceptance Assistant Director, Water Department CGc�1J'tD,�G�� ffG%��f�� Christopher Hard r(Jan 30, 2026 15:33:12 CST) Accepted Director, Water Department $ 2,792,412.00 $0 $ 2,792,412.00 $ 2,566,302.00 0 Days @ $ b00.00 / Day $ 0.0 $ 2,566,302.00 $ 2,437,986.90 $ 128,315.10 r ' i � z� ?� ; ; Date O1/30/2026 Date OFFICIAL RECORD CITY SECRETARY FT. WORTH, TX - ._ .��_ .'�r'_ '` �:-� �_. '"J --_'r. 'T_' � '_ Y.. k - ' _�.,. , j ' ,-�1 . � l, ♦ , - • , _ 1 . ti . . ! ... � t s . " . . � . _ !� .. � . FQ RT W4 RT H '�°.'2,26,25 �.�--�.,.�- FINAL STATEMENT OF CONTRACT TIME STATEMLNT NO.: � � AND FINAL NAME OF PROJECT': Walnut Creek Sanitary Sewer Intercebtor Extension PROJECT NO.: 103414-2 DOE NO.: N�q CONTRACTOR: Jackson P�RIOD FROM: � 2/01/25 T0� 12/�_ FINAL INSP�CTION DAT�: 12/02/25 WORK ORDER L+'FFECTIVE: 02/10/25 CONTRACT TIME: DAY Or O WD �(CD DAY OF �AYS I R�ASON FOR DAYS I DAYS I�ASON FOR DAYS MONTFI DURING I CREDITED M�N�j� I C DURING I CREDITED 1• Man � 16. 2. Tues � 17. 3. 18. 4. 19. 5. 20. 6. 21. - - - - -- - 7. 22. 8. 23. . ____--_ _---- . 9. 24. _ ._ _. - -- --- -- ---- 10. 25. 11. 26. -- 12. 27. . _ ____. _ _ __ _-- - -- 13. 28. -- __ —_ _ - - _ 14. 29. 15. 30. 31. SAT, SUN, & RAIN, TOO WET, UTILITIES pTHERS * DAYS TOTAL I30LIDAYS & TOO COLD I2�LOCATIONS C�IARGED DAYS T�s o 288 288 PERIOD PR�VIOUS 2 2 2 P�RIOD TOTALS 2 29� 29� TO DATE *REMARKS: , ,+ 1 ..� ___--- -- _ _ _--- ��`'��" , % '� /�.� d J CONTRACTOR DATE �' INSPECTOR DATE The City of Fort Worth • 100 Fort Worth Trail TX. 76102 (817) 392 -8275 � Jackson Construction LTD Item # Description Unit 1.006 �1� PVC ASTM F679 Se�@ r Pipe (and 18" MJ Piuq) Unit 1.007 Epoxy 5' Manhole Liner (VJarren or Chesterton Systems) Unit 1.008 5' Manhole Unit 1.009 5' Extra Depth Manhole Unit 1.010 Manhole Vaccum Testinp Unft 1.011 Concrete Collar Unit 1.0'I2 Manhole Vent and Odor Controi Assembiy Unit 1.0'13 T2ffic Control Unit 1.014 Post-CCN Inspection �Unit 1.015 Exploratory Excava5on of Existinq Utilities �Unit 1.016 Ground Wa(gr Control Unit 1.017 �ench Safety Unit 1.018 UtiliN Markers Unit 1.019 Remove Fence �Unit 'I.020 Concrete Encase Sewer Pipe Unit 1.021 SWPPP = 1 acre �Unit'1.022 Smooth �re F&nce, Metal Posts Unit �.023 16' Gate, Steel (4' Hiph -TxDOT Type 1) Unit �.024 4" Topsoil Import Unit 1.025 �Seedinp, Hydromulch �Unit 1.026 12"-18" Tree Removal Unit'1.027 24" and Larqer Tree Removai Unit 1.028 ?ree Protection Fencinq Unit 1.029 1'ree Protection Unit 1.030 � Temporary Construction Fencinq (5 Wire, Steei Post) Unit 1.031 edium Stone Riprap, dry Unit 1.032 �onstruction Stakinp Unit'1.033 edline Survey Unit 1.034' Construction Ailowance Unit 1.1B 24" Sewer Carrier Pipe (Fiberglass SN 72)' Unit 126 24" Fiberqiass SN72 Sewer Pipe, CLSM Backfitt' Unit'I.36 24" Fberqiass SN72 Sewer Pipe' Unit 1.46 27" Fiberqiass SN72 Sewer Pipe' Unit 1.SA 42" Casing BV Other Than Open Cut' Total CSC# 61955 UoM Unit Cost Original QlY Original $55 Revised QTY Revised S$S QTY Completed dk VF EA � LS LF EA LS � LF CY LS EA SY SY EA EA LF EA LF SY LS LS LF LF LF LF LF $ 285.00 $ 650.00 $14,000.00 $ 300.00 $ 200.00 $ 1,000.00 $18,000.00 S 4,0�0.00 S 3.00 $ 1,500.00 $ 7.500.00 $ 2.00 $ 300.00 $ 4.00 5 1.000.00 $ 35,000.00 $ 25.00 � Z,000.00 � 3.00 � 2.00 � 1,500.00 5 3.000.00 $ 2.50 $ 250.00 $ 14.00 � �oo.00 $'I 2,000.00 $ 2,627.00 � 219.00 $ 323.00 $ 196.00 $ 289.00 � 1,615.00 10.00 136.00 10.00 n.00 10.00 10.00 4.00 'I .00 5,550.00 7.00 1.00 5,292.00 27.00 683.00 127.00 1.00 603.00 5.00 51,500.00 5'1,500.00 1.00 1.00 320.00 7.00 10,800.00 s2s.00 1.00 'I .00 218.00 610.00 4,472.00 2'10.00 218.00 $ 2,850.00 $ 68,400.00 3 140,000.00 $ 23,'100.00 $ 2,000.00 � 10,000.00 � 72,000.00 � 4,000.00 $ '16,650.00 $ 10,500.00 $ 7,500.00 $ 10,584.00 5 8,100.OD $ 2,732.00 $ 127,OOD.OD S 35,000.00 $ 15,075.00 $ 10,000.00 s �sa,soo.00 $ 103,000.00 5 1,500.00 � 3,000.00 $ 800.00 S 1,750.00 $ 151,200.00 $ s2,soo.00 $ 12,000.00 $ 2,627.00 5 150,000.00 $ 47,742.00 S '197,030.00 $ 876,512.00 S 60.690.00 5 352,070.00 $ 2,792,412.00 10.00 136.00 10.00 77.00 10.00 10.00 4.00 1.00 5,550.00 7.00 1.00 5,292.00 27.00 683.00 127.00 1.00 603.00 5.00 5'1,500.00 51.500.00 1.00 1.00 320.00 7.00 10,800.00 925.00 1.00 1.00 218.00 610.00 4.472.00 2'10.00 218.00 � 2.850.00 $ 88,400.00 S 140.000.00 S 23,'100.00 $ 2,000.00 � 10,000.00 $ 72,000.00 $ 4,000.00 � 16.650.00 $ '10,500.00 � 7,500.00 5 10,584.00 $ 8,100.00 $ 2,732.00 $ '127,000.00 $ 35,OOD.00 S 15,075.00 $ 10,000.00 s �sa,soo.00 $ 103,D00.00 � 1,500.00 $ 3,000.00 $ 800.00 $ 1,750.00 $ 151,200.00 $ 92,500.00 $ 'I2,000.00 $ 2,627.00 � 150,000.00 $ 47,742.00 $ 197,03�.00 S 876,512.D0 S 60,690.00 5 352,070.00 S 2,792,412.00 '10.00 137.70 '10.00 77.00 10.00 10.00 4.00 1.00 5.550.00 7.00 1.00 5,292.00 27.00 300.00 127.00 1.00 126.00 5.00 5 � ,500.00 51.500.00 1.00 ,.00 6,166.00 925.00 7.00 1.00 z2o.00 610.00 4,472.00 210.00 220.00 3 $ � $ $ S S � $ $ S � S $ S � 3 $ s 5 $ i S S S S s S 5 s S S S � 5 Totai Work Completed 2, 850.00 89,505.00 140.000.00 23,100.00 2,000.00 10,000.00 72,000.00 4,000.00 '16,65D.00 '10,500.00 7,500.00 10,584.00 8.100.00 1,200.00 �27,000.�0 35, 000.00 3,150.00 10.000.00 isa,soo.00 'I 03,000.00 1,500.00 3,000.00 86,324.00 92,500.00 12,000.00 2,627 00 as.�ao.00 197,030.00 876,512.00 60,690.00 355,300.00 2,566,302.00 Walnut Creek SS Extension Retainage � 142.50 $ 4,475.25 � 7.000.00 $ 1,155.00 S 1 D0.00 $ 500.00 5 3.600.00 5 200.00 5 832.50 $ 525.00 $ 375.00 S 529.20 S 4D5.00 5 60.00 5 6.350.00 S 1,750.00 $ 157.50 5 500.00 s �,�2s.00 5 5,150.00 � 75.00 $ 150.00 � - $ $ 4,316.20 $ 4,625.00 $ 600.00 $ 131.35 $ - S 2,409.00 5 9.851.50 $ 43,825.60 5 3,034.50 $ 17,765.00 S 128,315.10 Net Paid $ 2,707.50 � 85.D29.75 5 133,000.00 � 2'1,945.00 $ 1,900.00 S 9,500.00 $ 68,400.00 S 3,800.00 $ 15,8'17.50 � 9,975.00 $ 7,125.00 S 10,054.80 S 7,695.00 $ '1,140.00 $ 120,650.00 5 33,250.00 $ 2,992.50 � 9,500.00 � �as.ns.00 S 97,850.00 $ 1,425.00 $ 2,850.00 � - S - 5 82,007.80 5 87.875.00 ^� 11,400.00 S 2,495.65 S - $ 45,771.00 5 187,178.50 S 832,686.40 $ 57,655.50 S 337.535.00 S 2,437,986.90 CPNR 103414 1/ 1 1/26/2026 Original Contract Change Orders Revised Contract Total Work Completed Less Deductions Liquidated Damages Other Deductions Total Work Completed Less: Prior Payments Total Amount Due $ 2,792,412.00 $ - $ 2,792,412.00 $2,566,302.00 $ - $ - $ 2,566,302.00 $ 2,437,986.90 $ 128,315.10 R �ORT�VORTH � Water DePartment PIPE I2EPORT rOR: PROJCCT NAMG: Walnut Creek SS Intercepter Extension CITY PROJ�CT NUMB�R: 103414-2 � WATER PIPC LAID SIZ� 'I'YPC OF' PIPG No FIR� HYDRANTS: N/A PIP� ABANDONGD No PIPG R�MOVCD No D�NSITI�S: N�W S�RVIC�S: � PIP� LAID Open Cut Open Cut SIZ� ��ra.d VALV�S (16" OR LARG�R) TYP� OI+ PIP� PIP� ABANDON�D D�NSITIGS: N�W S�RVIC�S: No TYP� Or PIP� S�W�R SIZ� TYPE Or PIPG 24" Fiberglass 18' PVC SIZ� TYP� OI' PIPG Yes rort \�/oith VUatcr Dcpartment The City of Fort Worth • 100 Fort VUorth Tr. 76102 C�l�l LF LF LF 5510' 10' Lr Fo �x �Vo RT x � Date: 01/22/26 RE; Acceptance Letter Project Name: Walnut Creel< Sanitary Sewer Interceptor Extension Ph 2 Project Type: Installation of 24" & 18" Sewer Project No: 103414-2 Contract No: 61955 To Whom It May Concern: On December 2nd 2025 a final inspection was made on the subject project There were no pu nch list items identified at that time. The final inspection indicates that the work meets the City of Fort Worth specifications and is therefore accepted by the City, The warranty period will start on which is the date of the final inspection and will extend of two (2) years in accordance with the Contract Documents. If you have any questions concerning this letter of acceptance, please feel free to contact me at (g17) 392- 6054 Sincerely, 6 n S � `' �, .� Tony Sholola, P.E., Assistant Director, Water Department TS / Cc: Chris Harder, P.E., Director, Water Department Laura Wiison, P.E. Deputy Director Water Department I<C Preeti P.E. Project Manager Victor V. Tornero Jr., P.E.,Sr. Capital Projects Officer" Wade Miller, Construction Manager John Robinson, Inspection Supervisor Stephen Martinez, Construction Inspector Carmen Dral<e, Senior inspector I<imley Horn, Consultant Jacl<son Construction, Contractor FORT WORTH . � � , Water DeparM�ent Conti•actoi•s �valuation of the City 1) PROJGCT INrORMATION Nnn7e ojConrrnclor Jacicson Construction lnspeclor Stephen Mactinez Cil�� Projecl N+�u�Ger Project Di�ciJlp Q Simple Q Routine Q Complex lnirinl CoiUr�rc( il n�onnt 2,792,412.00 II) P�RrORMANC� �VALUATtON _ ! '1 0- Inadequate 1- Deficient 2- Standacd 3- Good 4- Excellent GLGMENT I RATING ELEMENT (o-�) IRATING �o-a� INSP�CTION �VALUATION PLANS & SP�CIFICATIOiVS 1 Availability of Inspector � 1 Accuracy of Plans to Existing Couditions f� 2 ICnowledge of Inspector _ 2 Clarity & Suf'ficiency of Details ___ ___ 3 Accuracy of Measured Quantities 3 Applicability of Specifications _ ___�, 4 Display Of Professionalism I 4 Accuracy of Plan Quantities 1�� S Citizeu Complaint Resolution PROJ�CT MANAG�R �VALUATION 6 Performance - Setting up Valve Crews, Labs __� _j�� 1 I<nowledge And/Or Probleni Resolution ��:;� ADMINISTRATION 2 AvailaUility of Project Manager �_ __� 1 Change Order Processing Time l,� � 3 Communication � 2 Timliness of Contractor Payments � 4 Resolution of Utility Conflicts � 3 Bid Opening to Pre-Con Meeting Timefi•ame _ ��/' __ III) COMM�NTS & SIGNATUR�S COA4A�IGNTS Signature Contractor Signat�n•e Inspector Signatuce Inspector's Supe�visor REV:12/2G/25 Date: � 11/17/2025 Projecl Na�nc Walnut Creelc SS Interceptor Extension Ph 2 Projeci Aln��nger ICC Preeti 7ppe oJContr�rcl ❑ Water � Waste Water ❑ Storm Drainage ❑ Pavement Finn! Conlrncl Aniounl 2,566,302.00 u The City of Fort ��/oxth • 100 Fort 1�/octh Tr. T17G102 817-392-8275 FORTWORTH ,� Capital Projects Deliveiy, Water Department Perforinance of Contractors Evaluation I) CON"TRACTOR & I'ROJ�CT DA'fA Nanie of Conb•nclor I Jacicson Construction IVnlcr Gugirreering Inspecla• Stephen Martinez IVnler Cngineering btspeclor Q Water [� Waste Water ❑ Storm Drainage Q Pavement Ilnilinl Conn•acl ilmounl 2,792,412.00 Fi�inl Conlrncl Amounl 2,56G,302.00 Rev: ia�a�ias Projed Nnnie Walnut Creelc SS Iuterceptor Extensiou Pli 2 CSC NuniGer G1955 Projecl A•Inn�ger ICC Preeti Projecl Di�c�dry Q Simple 0 Routine � Compiex Dale 11�1%�2�2$ II) P�RI'ORMANC� �VALUATION �0 - Inadequale 1- Deficient 2- Stand�rd 3- Good 4- Excellent �ELEMENT WE[GHT ( x ) APPL[CABLE (Y / N) I SubmissionofDocuments 2 Y �2 Public Notifications 5 Y �3 Plans on Site 5 Y �4 I'ield S��pervision IS Y 5 Work Perfonned l5 Y 6 rinished Product IS Y 7 JoU Site Safety 15 Y 8 Traffic Control Mainte��nce IS Y �9 Daily Clean Up 5 Y 10 Citizen's Compinint Resolution 5 Y 1 1 Property Itestoration 5 Y 12 After I-Iours Response 5 Y 13 Project Completion 5 Y III) CONTRACTOR'S RATING RATING (0 - 4) MAX SCORE 4 8 4 20 �I 20 4 GO 4 GO 4 GO 4 60 4 GO 4 20 a ao 4 20 4 20 4 20 TOTAL GLCMEN7' SCOIt� (A) BONUS POINTS (25 Maximum) (B) 7'O"1'AL SCORG (TS) M�ximu�u Score (MS) = 4d8 or sum of applicable element score ma�imums tivhicl� = 4d8 I2ating ( ITS / NIS] * 10�%) 448 / 448 = 100% Pcrformance Catcgory Excellent <20% = L�ndequ�Ae 20% to <d0% = Defrcienl 40% to <60% = Stm�drn�d 60% to <80% = Good >_80% = L�•ce/lenl Inspector's Commenfs (1NCLUDING C\PLANATION OP' I30NUS POINTS A�VARDCD) Signature Inspector ��//!;/�i'// l-�t-1 i � Signatuce Contractor Capital Projects Delivery, ��/ater Department The Ciry of Fort Worth • 100 Foct \Vorth T�, 7G102 SCOR� v �� .,=1<5 /�1�� ,/O / O � %a � � 0� �� (� ; �� C� d48 ��'�i��ji� - — (817) 392 -8275 CONS�NT OF SURETY COIVIPANY TO FINAL PAYMENT AtA DOCUMENT G747 PROJECT: (name, oddress) TO (Ownor) Bond No. 1110382 ARCHITGCT'S pROJECT N�: 'City of Fort Worth � CONTRACT FOR: Walnut Creek Sanitary Sewer Interceptor 200 Texas St. Extension - Phase 2 Fort Worth, TX 76102 CONTRACT DATG: � � CONTRACTOR: Jacl<son Construction, Ltd. 5112 Sun Valley Drive Fort Worth, TX 76119 In accordance wilti the provisions of the Contract between the Owner and the Contractor as indicated above, the (hore insert nAme end address of Surely Company) The Hanover Insurance Company 440 Lincoln Street , Worcester, MA 01653 , SURETY COMPANY, on b011d of (liero Insert nama end addross of Coniraclor) Jac{cson Construction, Ltd. 5112 Sun Vafley Drive Fort Worth, TX 76119 ,CONTRACTOR, hereby approvos of the finai payment to ihe Contractor, and agrees that final payment to the Contractor shall not relieve lhe Surely Company of any of (ts obl►gaUons to �nere inse�t narne and addross or ov�ner� City of Fort Worth 200 Texas St. Fort Worth, TX 76102 , OWNERS, as set foril� in tf�e said Surety Company's bond. IN WITNESS WHEF2EOF, lhe Su�ely Company has hereunto set its hand thfa Attest• 13th day of November, 2025 The Hanover Insurance Company Surety Company �i1 �`� 1,� S(gnature of�horized Representative (Seal): Clay Aikman, Surety Witness Misty Witt, Attorney-in-Fact Title NOTk: This form Is lo be usod as e companlon document to AIA DOCUMENT G706, CONTRACTOR'S AFPIp�ViT OF PAYMENT OF pEB7S AND CLNMS, Curreni Edillon OWNER ARCHITECT CONTRACTOR SURETY OTHER AIA DOCUlAENT G707 • CONSENT OF SURETY COMPANY TO FINAI PAYMENT • APRIL 1�J70 EOITION • AIAm ONE PAGE m 1970 � THE AMERICAN INSTITU7E OF ARCI�ITEC7S. 1735 NEW YORK AVE., NW, WASHING70N, D.C. 20008 THE HANOVERINSURANCE COMPANY MASSACHUSETTS BAYINSURANCE COMPANY CITIZENS INSURANCE COMPANY OF AMERICA POWER OF ATTORNEY THIS Power of Attorney Ilmits the acts of those named hereln, and tliey have no au(hority to bfnd the Company except tn tfie manner and to the extent herein stated. KNOW ALI. PERSONS BY THESE PRESENTS: That THE HANOVER INSURANCE COMPANY and MASSACHUSETTS BAY INSURANCE COMPANY, bolh being corporallons organized and exisling under lhe laws of tha Stala o( New Hampslilre, and CITIZENS INSURANCE COMPANY OF AMERICA, a corporation organized and exisling under the laws of the State of Michigan, (hereinafter individually and colleclively lha "Company") does heroby consillule and appoint, Jack M. Crowley, Laurie Pflug, Misty Wltt, Hoily Clevenger andlor Cittfstfne Ciinger Of Wlllis Towers Watson insurance Services West, lnc of Dailas, TX each individually, if there be more ihan one named, as its true and lawful altorney(s)-In-facl to sign, execute, seal, acknowledge and deliver for, and on ifs behaiF, and as Ils act and deed any place wilhin Ihe United Slales, any and all surely bonds, recognizances, undertakings, or other surely oblic�ations. Tl�e execution of such surety bonds, recoc�nlzances, underlakings or surety obligatlons, In pursuance of these presents, shall be as �inding upon lhe Company as if lhey had heen duly signed by the president and attested by the secrelary o( Iha Company, in lheir own proper persons. Provided however, lhat lhis power o( altorney limils llie acls of lhose named hereln; and lhey have no authority to bind lhe Company except in Ihe manner slaled and to the exlent of any Iimitatlon stated below: Any such obilgations in the United States, not to exceed Fifty Million a�id No/100 ($50,000,000) in any sii�gle tnstance That tiiis power is mado and oxecuted pursuant to Iho authorily of the ioliowing Resol�tfons passed by liio Board of Directors oisald Company, and said Resolutions remaln in full force and effecl: RESOLVED: That Ihe President or any Vice Presfdent, in conJunction with any Vice President, be and ihey hereby are authorized and empowered to appolnt Attorneys-In-fact of the Company, In its name and as it acts, to execule and acknowledge for and on its behalf as surety, any and all bonds, recognizances, contracts of indemnity, waivers of citation and all olherwritings obligalory in the nature tl�ereoF,wlth power to aUach thereto the seal of lhe Company. Any such wrilings so exocuted by such Atlorneys-in-facl shall 6e 6fnding upon lhe Company as if they had been duly exacuted and acknowledged by Ihe regularly elected officers of the Company In Ihelr own proper persons. RESOLVED: That any and all Powers of Attorney and Certified Copies of such Powers oF Attorney and certi(ication in respect Ihereto, granted and executed by the President or Vlce President in conjunction willi any Vice President of lhe Company, shall be binding on Ihe Company lo lhe same extenl as iFall signatures Ihereln were manually affixed, even though one or more of any such signalures thereon may ba facsimlle. (Adopted Oclober7,19B1— The Hanover Insurance Company; Adopted April 14, 1982 —Massachusetis Bay Insurance Company; Adopted September 7, 2001— Citizens Insurance Company ot America and affirmed by each Company on March 24, 2014) IN WITNESS WHEREOF, THE HANOVER INSURANCE COMPANY, MASSACHUSETTS BAY INSURANCE COMPANYand CITIZENS INSURANCE COMPANY OF AMERICA have caused these presenis to be sealed wilh thefr respective corporate seals, duly altested by hvo Vice Presfdenls, this 22nd day of April 2025 �AY y �` y.fF1'� ' ��,,,AAA��..wM� � �,J!yl / ��f=� v4j4\+ jT ��1 Q, I �� IIOf� 'i,i v�� .�.��.�' 7hc llanu�•c� Insur�ncc Compan� rinsaachuselle Rny Imurnncc Compqny Cllizens Ineur�ncc Compqny.nfAmcrica J a H. Kawlookl, co Pro� den� 7'lic Ilauo��cr Insuruncc CompAn�� 11 nchuaetu Ony Insurance Company f�ti ns Insu nncc Company otAmerlcn Ilon M, Mendoza, Vlce President STATE OF CONNECTICUT ) COUNTY OF HARTFORD ) ss. On this 22nd day of Aprii, 2025 before me came the above named Executive Vice President and Vice President of The Hanover Insurance Company, Massachuselts Bay Insurance Company and Cilizens Insurance Company of America, to me personally known to be ihe Individuals and oKcers described herein, and acknowledgad Ihat the seals a�xed to the preceding Inslrument are the corporate seals of The Hanover Insurance Company, Massachusells Bay Insurance Company and Cilizens Insurance Company of America, respectively, and that the said corporate seals and lhelr signatures as officers were duly affixed and subscribed to said inslrument by lhe authority and direction of said Corporations. � 1CATHLEEN M. SIRAiiD �—�, No1�my Public II I�p 1[Comnwnwaolth of Ma�sathuaetts �11[/� M�r Commiuton Expires ��'� S�ptsrob�r 2, 90�7 � a 1 aen M,Sirard, No a` uhllc My co mlesion expires, S tember 2, 2027 I, the underslgned Vlce Presidenl of The Hanover Insurance Company, Massachusetts Bay Insurance Company and Cltizens Insurance Company of America, hereby certify that the above and foregoing ts a full, true and correct copy of ihe Original Power of Attorney (ssued by said Companies, and do hereby furtherceriify thal the said Powers of Attorney are still In force and effect. GIVEN under my hand and the seals o( said Companies, al Worcester, Massachusetts, tliis 13ti1 day of NOvenlbec 2025 CERTIFIED COPY The �n e In�urance .ompa Mr rc U Day Int pnny CI ua �ura �cc Am ohn Ro�rnld<r, Vicc 1'raldcnl �� CONSTRUCTI � N LTD. 5I I 2 SUN'VALLEY D IVE FORT WOR7H, TX 761 19 � 7EL 817-572-3303 FAX: 8 I 7-478-0443 . . AFFIDAVIT STATE OF TEXAS COUNTY Or TARRANT Hefore me, the undersigned authority, a notary public in the state and county aforesaid, on tliis day personally appeared Troy L. Jackson, President Of �ackson Conshuction, Ltd, known to me to be a credible person, who being by me duly sworn, upon his oath deposed and said; . That all persons, firms, associations, corporations, or,other organizations furnishing labor and/or materials have been paid in full; That the wage scale established by the City Council in the City of Fort Waith has been paid in full; That there are no claims pending for persorial injury and/or property damages; On Contract described as; Walnut �reek Sanitary Sewer Interceptor Extension - Ph 2 BY � ��j � L�2%�I/Gl�fil � . `/`/ . Jackso Presideht , , Troy n, Subscribed and sworn before me on this date 13th of November, 2025.. • � Notary Pub ic . , � Tarrant, Texas . o"'�va"'�•,y CARMEN l.. ESTEP . . �,o��,`.., � �r; ,� � Notary Public. State oi Texas '%'�� ' Comm. Explres OA-08-2028 � '�. .�, '�.'�'„��`� � Notery ID 2910811 . �' , � i _ � _ • _ _ � _ _ � _ � — �- .� ��, —