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Home My WebLink About060706-FP1 - Construction-Related - Contract - RPMX ConstructionFQRT�VORTH� -FP1 City Secretary Contract No. 60706 Date Received 2�3/2026 AT NOTICE OF PROJECT COMPLETION (Developer Projects) The Transportation and Public Works Department upon the recommendation of the Project Manager has accepted the following project as complete: Project Name: Meadow Lakes Phase II City Project No.: 104081 Improvement Type(s): 0 Paving ❑ Drainage 0 Street Signs ❑ Turn Lane Original Contract Price: $1,515,943.50 Amount of Approved Change Order(s) Revised Contract Amount: Total Cost of Work Complete: TyCe�^ i-�e�Ce�y ��PTP�,�,�� P��, �,�,��,QQ a�,s�- Contractor Project Manager Title RPMX Construction Company Name o,�. �� Project Inspector �� Project Manager o�� CFA Manager �°�,..,?,..� �a�rer, P�re�r (reb s, zoze ii:iz�.ao csT; TPW Director 02/02/2026 Date 02/02/2026 Date 02/03/2026 Date 02/03/2026 Date 02/03/2026 Date $0.00 $1,515,943.50 $1,515,943.50 �FFICIAL RECORD CITY SECRETARY FT. WORTH, TX Page 1 of 2 Notice of Project Completion Project Name: Meadow Lakes Phase II City Project No.: 104081 City's Attachments Final Pay Estimate 0 Change Order(s): 0 Yes O N/A Contractor's Attachments Affidavit of Bills Paid � Consent of Surety � Statement of Contract Time Contract Time: 190 WD Work Start Date: 5/21 /2024 Completed number of Soil Lab Test: 1112 Completed number of Water Test: 41 Days Charged: 344 WD Complete Date: 1/8/2026 Page 2 of 2 FORTWORTH CITY OF FORT WORTH F1NAL PAYMENT REQUEST Contract Name MEADOW LAKES PHASE II Contract Limits Project Type PAVING & STREET SIGNS City Project Numbers 104081 DOE Number 4081 Estimate Number 1 Payment Number 1 For Period Ending City Secretary Contract Number Contract Date Project Manager NA Contractor RPMX CONSTRUCTION 5208 TENNYSON PARKWAY SUITE 130 PLANO� TX 75024 Inspectors G.DEYON / O.FRIAS Contract Time Days Charged to Date Contract is 100.00 1/8/2026 WD 190WD 344 Complete Friday, January 16, 2026 Page 1 of 4 City Project Numbers 104081 ContraCt Name MEADOW LAKES PHASE II Contract Limits Project Type PAVING & STREET SIGNS Project Funding UNTI' IV: PAVING IMPROVEMENTS Item Description of Items Estimated Unit No. Quanity 1 HYDRATED LIME 300 TN 2 6° LIME TREATMENT 21441 SY 3 2" ASPHALT PVMT TYPE D 717 SY 4 4" ASPHALT BASE TYPE B 717 SY 5 6" CONC PVMT 20058 SY 6 4" CONC SIDEWALK 5818 SF 7 BARRIER FREE RAMPT, TYPE R-1 4 EA 8 BARRIER FREE RAMP, TYPE P-1 10 EA 9 TOPSOIL 93 CY 10 SEEDING, HYDROMULCH 556 SY 11 TRAFFIC CONTROL 1 LS 12 REMOVE CONC CURB & GUTTER 57 LF 13 CONCRETE FLUME WITH CURB 3425 SF 14 CONNECT TO EXISTING PAVEMENT 115 LF 15 SAWCUT & CONNECT TO EXISTING ASPHALT 109 LF Sub-Total of Previous Unit — — — — — — — — — — — — — — — — — — — UN1T VI: STREET SIGN IMPROVEMENTS Item Description of Items Estimated Unit No. Quanity 1 FURNISH/INSTALL STREET SIGN POST 16 EA 2 FURNISH/INSTALL STREET NAME BLADE 32 EA 3 FURNISH/INSTALL STOP SIGN 12 EA Sub-Total of Previous Unit DOE Number 4081 Estimate Number 1 Payment Number 1 For Period Ending 1/8/2026 Unit Cost Estimated Completed Completed Total Quanity Total $297.50 $89,250.00 300 $89,250.00 $3.50 $75,043.50 21441 $75,043.50 $22.00 $15,774.00 717 $15,774.00 $39.50 $28,321.50 717 $28,321.50 $57.00 1,143,306.00 20058 '�1,143,306.00 $7.00 $40,726.00 5818 $40,726.00 $2,350.00 $9,400.00 4 $9,400.00 $2,350.00 $23,500.00 10 $23,500.00 $90.00 $8,370.00 93 $8,370.00 $4.75 $2,641.00 556 $2,641.00 $10,000.00 $10,000.00 1 $10,000.00 $12.00 $684.00 57 $684.00 $14.50 $49,662.50 3425 $49,662.50 $30.00 $3,450.00 115 $3,450.00 $35.00 $3,815.00 109 $3,815.00 $1,503,943.50 $1,503,943.50 Unit Cost Estimated Completed Completed Total Quanity Total $500.00 $8,000.00 16 $8,000.00 $50.00 $1,600.00 32 $1,600.00 $200.00 $2,400.00 12 $2,400.00 $12,000.00 $12,000.00 Friday, January 16, 2026 Page 2 of 4 City Project Numbers 104081 Contract Name MEADOW LAKES PHASE II Contract Limits Project Type PAVING & STREET SIGNS Project Funding Contract Information Summary Original Contract Amount Change Orders DOE Number 4081 Estimate Number 1 Payment Number 1 For Period Ending 1/8/2026 $1,515,943.50 Total Contract Price $1,515,943.50 Total Cost of Work Completed $1,515,943.50 Less % Retained $0.00 Net Earned $1,515,943.50 Earned This Period $1,515,943.50 Retainage This Period �0.00 Less Liquidated Damages Days @ / Day LessPavement Deficiency Less Penalty Less Previous Payment Plus Material on Hand Less 15% Balance Due This Payment $0.00 $0.00 $0.00 $0.00 $0.00 $1,515,943.50 Friday, January 16, 2026 Page 3 of 4 City Project Numbers 104081 ContraCt Name MEADOW LAKES PHASE II Contract Limits Project Type PAVING & STREET SIGNS DOE Number 4081 Estimate Number 1 Payment Number 1 For Period Ending 1/8/2026 Project Funding Project Manager NA InSpeCtors G.DEYON / O.FRIAS Contractor RPMX CONSTRUCTION 5208 TENNYSON PARKWAY SUITE 130 PLANO, TX 75024 City Secretary Contract Number Contract Date Contract Time 190WD Days Charged to Date 344 WD Contract is 000000 Complete CITY OF FORT WORTH SUMMARY OF CHARGES Line Fund Account Center Amount Gross Retainage Net Funded Total Cost of Work Completed Less % Retained Net Earned Earned This Period $1,515,943.50 Retainage This Period $0.00 Less Liquidated Damages � Days @ $0.00 / Day LessPavement Deficiency Less Penalty Less Previous Payment Plus Material on Hand Less 15% Balance Due This Payment $1,515,943.50 $0.00 $1,515,943.50 $0.00 $0.00 $0.00 $0.00 $0.00 $1,515,943.50 Friday, January 16, 2026 Page 4 of 4 ��RT ��RTH�, City Secretary's Office Contract Routing & Transmittal Slip Contractor's Name: Venus Construction Subj ect of the Agreement: Meadow Lakes Phase II / CSC NO. 60706 . - Revised sewer pay item 21 quantity, to account for the rounding error in the ariginal bid proposal. - Added 'Street Sign' pay items to 'Street Lighting' (Bid Items #7-9), to match the original bid and CFA. M&C Approved by the Council? * Yes ❑ No � If �so, lhe M&C must be altached lo lhe conlract. Is this an Amendment to an Existing contract? Yes ❑ No C� If so, provide the original contract numher and the amendment number. Is the Contract "Permanent"? *Yes � No ❑ If unsuNe, see back page, for permanent contract listing. Is this entire contract Confidential? *Yes ❑ No � If only specific infor�nation is Confidential, please list what information is Confidential and the page it is located. Effective Date: oi/o�/2026 If different, from the approval date. Expiration Date: If applicable. Is a 1295 Form required? * Yes ❑ No � *If so, please ensure it is allached lo the approving M&C or attached to the contract. Proj eCt Number: If applicable. 104081 *Did you include a Text field on the contract to add the City Secretary Contract (CSC) number? Yes C�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 returned to the department. CSC No. 60706-0O2 DEVELOPER-AWARDED-PROJECT CHANGE ORDER PROJECT NAME: CONTRACT: CFA # CITY PROJECT # CITY SECRETARY CONTRACT # FID # X# FILE # INSPECTOR: PROJECT MANAGER: ORIGINAL CONTRACT EXTRAS TO DATE CREDITS TO DATE CONTRACT TO DATE AMOUNT OF PROP. CHANGE ORDER REVISED CONTRACTAMOUNT TOTAL REVISED CONTRACT AMOUNT PER UNIT REVISED COST SHARE TOTAL REVISED CONTRACT Meadow Lakes Phase II Water, Sewer Paving, Drainage & Street Lights Improvements 23-0147 � CITY PARTICIPATION: 104081 60706 0114-0200431-104081-E07685 27330 W-2831 CHANGE ORDER No: YES %a Omar Frias Phone No: (817) 647-2497 George Marquez, P.E. Phone No: (817) 392-6826 CONTRACT UNIT WATER I SEWER I DRAINAGE I PAVING I STREET LIGHTS Developer Cost City Cost Developer Cost City Cost Developer Cost City Cost Developer Cost City Cost Developer Cost City Cost $789,409.48 I $73,380.24 $1,140,135.82 $404,732.09 $388,704.32 $0.00 I $1,503,943.50 $0.00 $153,605.00 I $0.00 $246.24 I $14,483.50 $4,726.40 $71,987.50 $0.00 $0.00 I $0.00 $0.00 $0.00 I $0.00 $0.00 I $0.00 $0.00 $0.00 $0.00 $0.00 I $0.00 $0.00 $0.00 I $0.00 $789,655.72 I $87,863.74 $1,144,862.22 $476,719.59 $388,704.32 $0.00 I $1,503,943.50 $0.00 $153,605.00 I $0.00 $0.00 I $0.00 $0.70 $0.00 $0.00 $0.00 I $0.00 $0.00 $12,000.00 I $0.00 $789,655.72 I $87,863.74 $1,144,862.92 $476,719.59 $388,704.32 $0.00 I $1,503,943.50 $0.00 $165,605.00 I $0.00 $877,519.46 $1,621,582.51 $388,704.32 $1,503,943.50 $165,605.00 Dev. Cost: $3,992,771.46 City Cost: $564,583.33 $4,557,354.79 CONTRACT DAYS 190 110 0 300 0 300 Page 1 You are directed to make the following changes in the contract documents. IUNIT II: SANITARY SEWER IMPROVEMENTS PAY ITEM # CITV BID ITEM # QUANTITY UNIT ITEM DESCRIPTION 21 33 39 60 -170.00 VF 3339.0001 Epoxy Manhole Liner 21 33 39 60 170.00 VF 3339.0001 Epoxy Manhole Liner TOTAL UNIT II: SANITARY SEWER IMPROVEMENTS Item 21 � Total sewer unit price in the original bid proposal had a rounding error of $0.70. Change order revises sewer item 21 to account for this rounding error. IUNIT V: STREET LIGHTING IMPROVE ENTS PAY ITEM # CITV BID ITEM # QUANTITY UNIT ITEM DESCRIPTION 7 34 41 30 16.00 EA 9999.0008 Furnish/Install Street Sign Post 8 34 41 30 32.00 EA 9999.0009 Furnish/Install Street Name Blade 9 34 41 30 12.00 EA 9999.0010 Furnish/Install Stop Sign TOTAL UNIT V: STREET LIGHTING I P VEMENT Items 7-9: Added'Street Sign Improvements' pay items to'Street Lighting Improvements' unit to match the origina ic�proposa and CFA. UNITPRICE DeveloperCost $624.71 $ 106,200.00' $624.71 $ 106,200.70 $ 0.70 UNITPRICE DeveloperCost $500.00 $ 8,000.00 $50.00 $ 1,600.00 $200.00 $ 2,400.00 $ 12,000.00 Cost TOTAL $0.00 $ 106,200.00 $0.00 $ 106,200.70 - $ 0.70 Cost TOTAL $0.00 $ 8,000.00 $0.00 $ 1,600.00 $0.00 $ 2,400.00 - $ 72,000.00 Page 2 . the originai bid proP°Sal. Adde ds treet S�gn Work items to 'Street PppRpVED= Inc. for the roundm9 error in „struct�on, p1107126 �e��s C� ��t �ate. a��ount and GFA. � � �t 21 quantitYthe origina� bid Struction, ��" /�r"f ed SeWer Pa s�#7 g�, to match AppROeVe oPment and �On q110�i26 By� McPda �osh RgVis Item Iite D pate�. NaR,e: S� �ato CHpNG,E OR�E Lighting' B�d E � � puthorized N� `EGA�1' f'r; R � SF�R ��ENDE�``� '(it1e� FppN1A REAS�N FIEC �Sulta�ts By: hehata pg'(O pNP CO �oh� S APPRpVEO r . p1107126 ��tY pttorneY �% Date• Name ��ner � _ AssisCa�� paCe: oii��o2 CF 1 BY�• T'd1e� F �' APpRpVE�: r�z�Sru�, � � �ken Na�G t�ana er Ssistant �iry Mana9e� p1I2312026 0Y• RichardM°�ra co��►ENpEp. GFW'A Date' Name' t P�°rne 1it\e: Pp°pP O RE (� V A� o� \ 1 � p,ssda�� . pepartment �� ""� 1it1e: �F�y _ vyater o�i2iizozs BY�• ``� JeslcaMcEachern Mana9er1� �� pate'. e�, ana er er �proyect ��lr,��. Nan` Git M �ana9 on resP°�S�b1Ude �ug� p,ssistant . �or+tract Co�'plian�6 ers Tit1e�. t 1 am th oPt�,s �on<ra�t, in �fi"f By e w,ed9e tha �ts� Sub varu hes � ackno adm��strati�on� �equ�reme me: BY S�9n�n9 rmance a�d reP°ri g tira�t a � �tor�n9 and n r;,N Na an e Tic1e: En �nee�M M oi126I2026 for the m�a, perfo d With ih�s Esj ens�r�n9 ds associate p'R pate: N� G��Y Fu� �th th�s GO�tra�t REC�MMENDED• �omP�ia��e �ana9er �`�`' 4 the�e a�e ds asso��a<ed ,�;,�.�:- GoodaU Gity Fun eFW .�onUaat oii2o�2oz6 g �, � � ?here are Date' �anne�e S• � �„R,� �.1ame� �retarY ��„t�a, CiY Se BY� T�t1e: Name'. GeOr e Mar ueZ ana er cFW PrpectM `% '(itle'. zg.1011 N1&G N�mber 1 tl28/2023 M&c Date PPprQ�ed�. Page 3 �`o�� rx� TRANSPORTATION AND PUBLIC WORKS January 15, 2026 RPM xConstruction LLC 6500 Meyer Way, Ste. 100 McKinney, TX 75070 RE: Acceptance Letter Project Name: Meadow Lakes Phase 2 Project Type: Paving City Project No.: 104081 To Whom It May Concern: On January 9, 2026 a final inspection was made on the subject project. There were punch list items identified at that time. The punch list items were completed on January 15, 2026. The final inspection and the corrected punch list items indicate that the work meets the City of Fort Worth specifications and is therefore accepted by the City. The warranty period will start on January 15, 2026, which is the date of the punch list completion and will extend of two (2) years in accordance with the Contract Documents. If you have any questions concerning this letter of acceptance, please feel free to contact me at 817- 392-6826. Sincerely, �� George Marquez , Project Manager Cc: Omar Frias, Inspector Gary Deyon, Inspection Supervisor Lorrie Pitts, Senior Inspector Andrew Goodman, Program Manager ANA Consultants LLC, Consultant RPM xConstruction LLC, Contractor Elite Development and Construction LLC, Developer File E-Mail: TPW_Acceptance@fortworthtexas.gov Rev. 8/20/19 AFFIDAVIT STATE OF TEXAS COUNTY OF COLLIN Before me, the undersigned authority, a notary public in the state and county aforesaid, on this day personally appeared Mendy McCann, CFO Of RPM xConstruction, LLC, known to me to be a credible person, who being by me duly sworn, upon his oath deposed and said; That all persons, firms, associations, corporations, or other organizations furnishing labor and/or materials have been paid in full; That the wage scale established by the City Council in the City of Fort Worth has been paid in full; That there are no claims pending for personal injury and/or property damages; On Contract described as; Meadow Lakes Phase 2 Paving BY � �� Mendy McCann, CFO Subscribed and sworn before me on this date 2nd of February, 2026. _s�n�t� Notary Public Collin County, Texas `\\``,�1U I N i 1 U pr�l��'i `�� AU R E^, �,,� ;.4p : P�Y'p�e. 94��: � � . 2�l �y.� � � _ � J+.� � Q fA = .�. .��a��:^ ; �, F ••. �32��'.� ' r�, \: �, � . '��i��`A, �9„ 3;2 ��\ C�NSENT OF SURETY COMPANY TO FINAL PAYMENT AIA DOCUMENT G707 PROJECT: {itamc, address) TO (Owner) [ Meadow LRkes Phase II City of Fort Worth 200 Texas Street Fort Worth,l'X 76102 � � � ARCHITCCT'S PR0IECT NO: CONTRACT FOR: CONTRACT DATE: CQNTRACTOF�: RPM xConstructioo, LLC b500 Meyer W�iy, Suite I00 McKinney, TX 75070 In accordance �vith d�e pro�isions oF the Co«tract bet�veen tfie Q�vner and the Contractar as indicated abo��, the (hcrc inscrt narzu: and address of Surety Compaii��) Swiss Re Cor�orate Solutions America Insurance Corporation i240 Mair� 5t., S��ite 800 , SURETY CQMPANY, on Uond of (here inscrt n��me ai�d address oS� Coiltractor) RPM sConstruction, LLC 6500 Meyer Way, Suite 100 McKinney, TX 75070 , CQNTRACTOR, liereby approves of the fiilal �aymeijt to the Contractors, and agrees tEiat �inal payeZZent to the Contractor shall not r�lieve the Surety Company of any of its obligatio��s to (E�crc inscrt n��s„c �nci �jddress of()tivncr) City of Fort Worth 200 Texas Strcet �'ort Worth, TX 76102 �� as set forth in the said Surety Company's bond. 1N WITNESS WHI:REOF, tlie StErety Comp�tny has Itereu�ito set its hand this 30th Attest: / ��`, (Seal): �� U day of JanuRry 2{�26 Swiss Re Cor�arate Solutions America Insurance Surety Cosnpany �� 7 ! W �� . _ Signature of Auil7arized Re�resentative Andrea Rose Crawford Attorney-In-�'act Title NO"I�L. "I'his fomi is to hc uscd as a camp�jnicm ducumcnt to A[A DOCU�fI:�"I' G705, COt+i�fRAC"I�OR'S r1Fl�[DAV[�C OF PnYMf:y"I� OI� DIiBTS A�D C[,AIMS, Currcnt fidilion o�v��:rz ❑ n�cr�rr�:cr ❑ co��rEinc�ro� ❑ SUR�:"CY ❑ O"I I ll;lt Bond No. 2352563 Nn I�OCl1M1iNl� C;707 • C[)�!SEN'f OF SURIi fY COVIYnNY TO I�[NnL Pr1YMF:\"I' • APRIL I�}7U I:bl'I'[ON • AIAb O�fli PAUI: O[970 • 7�llli AN31iEtICAA1 [NS'[�ITU7'[? pl� /�RClil"I�EC"[�S> 173� Netiv York 11vc., NW, WA5[I[NG'COA1, D.C. 20006 SW1SS RE CORPORATE SOLUTIONS SWISS RE CORPORATE SOLU"C[ONS AMERICA INSURANCE CORPORATION ("SRCSAIC") SWISS RE CORPORA'I'E SOLUTfONS PREMIER INSURANCE CORPORAT[ON ("SRCSPIC") W ES'fPORT INSURANCE CORPORATION ("W IC") GENERAL POWER OF ATTORNEY KNOW ALL MEN BY THESE PRESENTS, THAT SRCSAIC, a corporation duly organized and existing under laws of the State of Missouri, and having its principal oflice in the Ciry of Kansas City, Missouri, and SRCSPIC, a corporation organized and existing under the laws of the Stale of Missouri and having its principal ofiice in the City of Kansas City, Missouri, and WIC, organized under the laws of the State of Missouri, and having its principal office in the City of Kansas City, Missouri, each does hereby make, constitute and appoint: JOHN R. WARD, THOMAS DOUGLAS MOORG, rMILY ALLISON MIKESKA, ALLYSON W. DEAN, MONICA RUBY VEAZGY, JOHN WILLIAM NEWBY, TROY RUSSELL KEY, DEBRA LEE MOON, ANDREA ROSE C(tAWFORD. SANDRA LEE RONEY, FAITI t ANN IItL7Y, ANDREW GARETII ADDISON, PATRICK TIIOMAS COYLE. M1CI IAEL DO`IALD I IENDRICKSON. BRYAN ICELLY MOORIi. F:LI%ABE"I'l l ORTIZ, ANA OWE1V5. Bh'TIY 1 REEI I. AND ANDREW PATRICK CLARK 1014TLY OR SEVERALLY Its true and lawful Attomey(s)-in-Fact, to make, execute, scal and deliver, for and on its behalf and as its act and deed, bonds or other writings obligatory in the naturc of a bond on behalf of each of said Companies, as surety, on contracts of suretyship as are or may be required or permitted by law, regulation, contract or othenvise, provided that no bond or undertaking or contract or suretyship executed under this authority shall exceed lhe amount of: TWO I IUNDRED MILLION (S200,000,000.00) DOLLARS This Power of Attorney is granted and is signed by facsimile under and by the authority of the following Resolutions adopted by the Boards of Directors of both SRCSAIC and SRCSPIC at meetings duly called and held on the 18th of November 2021 and WIC by written consent of its Executive Committee dated July 18, 201 l. "RESOLVED, that any t�vo of the Presidenl, any Managing Director, any Senior Vice President, any Vice President, the Secretary or any Assistant Secretazy be, and each or any of them hereby is, authorized to execule a Power of Attorney qualifying the attomey named in the given Power of Attorncy to execute on behalf of the Corporation bonds, undertakings and all contracts of surery, and that esch or any of them hereby is authorized to attest to the execution of any such PoW�er of Attorncy and to attach therein the scal of the Corporation; and it is Fi1RTHER RESOLVED, that the signature of such officers and the seal of the Corporation may be affixed to any such Power of Attorney or to any certificate rclating thereto by facsimile, and any such Power of Attomey or ccrtificate bearing such facsimile signatures or facsimile seal shall be bindina uoon the Corporation when so affixed and in the future with reeard to anv bond, undertaking or contract of surety to which it is attaclied." , � � .• J��pNS FREM�4�rQ''•. y0`', QftPOqq�,��y; _ S EAL�: (�� .�::i.,ti��:.P,.._ _. By .'� ENk Jannena, Senior Ya Pruidmt of SRCSAIC & SeaiarYce Presidaet of SRCSP[C & Senior Viee PreBdm� of 1VIC B� -�-�� Gendd Js;rowalu, wu Prctident ofSR6A1C &�iec Preildmt ofSRCSPIC & Viee Praidml of WIC IN W ITNESS WHERGOr, SRCSAIC, SRCSAIC, and WIC have caused their official seals to bc hereunto affixed, and these presents to be signed by thcir authorizcd o�cers �,is 1�� day of January , Zp 24 State of Illinois CounryofCook � Swiss Re Cor�orate Solutions America Insurance Corporation Swiss Re Corporate Solutions Premicr [nsurance Corporation Westport [nsarance Corporation On this 11th day of �anuary � ZO 2� , bcfore me, a Notary Aublic personally appearcd Erik Janssens , Senior Vice President of SRCSAIC and Senior Vice President of SRCSPIC and Seniar Vice Pmsidcnt of WIC and Gerald Ja rg owski , Vicc President ofSRCSAIC and Vice President of SPCSPIC and Vice President of WIC, personally known to me, who being by me duly s�vom, acknowledged that they signed U�c above Power of Attorncy as oflicers of and acknowledged said inswment to be the voluntary act and deed of their respcctivc companies. aa�cu+L eEA� ST11.'�A MAFH$CO NOT!{tl�l. 8'FJhE0F�1N01B, �AMu�GO � 1h.Cei�ur�'ii E+4iieti Msm I, JefGev Goldbera, the duly elected Senior Vice President and Assistant Secretary of SRCSAIC and SRCSPIC and WIC, do hereby certi}'y that the attove and forcgoing is a true and cotrect copy of a Power of Atlomcy given by said SRCSAIC and SRCSPIC and WIC, which is still in full force and cffect. IN W17'NESS WHEREOF, [ havc sct my hand and affixcd Uic scals of thc Companies this 30 �y o f January , Zp �. �'�' __c. .- Jeffrcy Goldberg, Senior Vice Presidcnt & Assistant Secmtary of SRCSAIC and SRCSPIC and WiC \/'� C :\ \� In order to obtain information or make a complaint: You may contact the Surety Claims Department at 1-816-235-3702 You may call Swiss Re Corgorate Solutions America Insurance Corporation or Swiss Re Corporate Solutions Premier Insurance Corporation for information or to make a complaint at: 1-816-235-3702 You may also write to Swiss Re Corgorate Solutions America Insuraace Corgoration or S�viss Re Corporate Solurions Premier Insurance Corgoration at the following address: 12Q0 Main Street, Suite 800 Kansas City, MO 64105 You may contact the Tezas 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: httn://www.tdi.state.tx.us E-mail:Co nsu merProtection(a�tdi.ctate. tx. us PREMIUM OR CLAIM DISPUTES: Should you have a dispute concerning your premium or about a claim you should first contact the Swiss Re Corgorate Solutions America Insurance Corgoration or Swiss Re Corporate Solutions Premier Insurance Corporation. If the dispute is not resolved, you may contact the Texas Department of Insurance. ATTACH THIS NOTICE TO YOUR POLICY: This notice is for information only and does not become a part or condition of the attached document. � 1/ I' 1 : _ \ Para obtener informacion o para someter un queja: al 1-816-235-3702. Puede comunicarse con Surety Claims Departmeat Usted puede Ilamar Swiss Re Corporate Solutions America Insurance Corporation o Swiss Re Corgorate Solutions Premier Insurance Corgoration para informacion o para someter una queja al: 1-816-235-3702 Usted tambien puede escribir a Swiss Re Corporate Solutions America Insurance Corporation o Swiss Re Corporate Solutions Premier Insurance Corporation al: 1200 Main Street, Suite 8Q(1 Kansas City, MO 64105 Puede escribir al Departmento de Seguros de Texas para obtener informacion acerca c!e companias, coberturas, derechos o quejas al: 1- 800-252-3439 Puede escribir al Departmento de Seguros de Texas: P.O. Box 149104 Austin, TX 787149104 Fax: (512) 475-1771 Web: httn://www.tdi.state.hc.Lc E-mail:�oncL merPrntecN�nntdi.state. bc. Ls DISPUTAS SOBRE PRIMAS O RECLAMOS: Si tiene una disputa concerniente a su prima o a un reclamo, debe comunicarse con el Swiss Re Corporate Solutions America Insurance Corporation o Swiss Re Corporate Solutions Premier Insurance Corporation primero. Si no se resuelve la disputa, puede entonces comunicarse con el Departmento de Seguros de Texas. UNA ESTE AVISO A SU POLIZA: Este aviso es solo para proposito de infromacion y no se converte en parte o condicion del documento adjunto.