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Home My WebLink About062975-FP1 - Construction-Related - Contract - Burnsco Construction, Inc.-FP1 FQRT WQRTHo City Secretary 62975 Contract No. Date Received 2�25�2�26 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: North Side Pressure Plane 2.5 City Project No.: 105519 Improvement Type(s): Water 0 Original Contract Price: Water Original Contract Price: Sewer Water & Sewer Original ContractTotal Amount of Approved Change Order(s): Water Amount of Approved Change Order(s): Sewer Revised ContractAmount: Water Revised ContractAmount: Sewer Total Cost of Work Complete Sewer ❑ Developer Cost City Cost $19,395.21 $561,299.79 $0.00 $0.00 $19,395.21 $561,299.79 $1,409.48 $40,790.52 $0.00 $0.00 $20,804.69 $602,090.31 $0.00 $0.00 $20,804.69 $602,090.31 �Q��ont �a��doti Ain��ra� m�rFe�za 2s,00sz2o Contractor Vice President Title Burnsco Construction, Inc. Company Name �� Project Inspector a��.�� Project Manager a�� CFA Manager �� Lauren Prieur (Feb 25, 2026 16:39:48 CST) TPW Director 02/24/2026 Date 02/24/2026 Date 02/25/2026 Date 02/25/2026 Date 02/25/2026 Date Total Cost $580,695.0 $0.0 $580,695.0 $42,200.0 $0.0 $622,895.0 $0.0 $622,895.0 OFFICIAL RECORD CITY SECRETARY FT. WORTH, TX Page 1 of 2 Notice of Project Completion Project Name: North Side Pressure Plane 2.5 City Project No.: 105519 City's Attachments Final Pay Estimate 0 Change Order(s): 0 Yes ❑ N/A Pipe Report: 0 Yes ❑ N/A Contractor's Attachments Affidavit of Bills Paid � Consent of Surety � Statement of Contract Time Contract Time: 40 WD Days Charged: 20 WD Work Start Date: 12/9/2025 Work Complete Date: 1/7/2026 Completed number of Soil Lab Test: 11 Completed number of Water Test: 0 Page 2 of 2 FORTWORTH CITY OF FORT WORTH F1NAL PAYMENT REQUEST Contract Name NORTH SIDE PRESSURE PLANE 2.5 Contract Limits Project Type WATER City Project Numbers 105519 DOE Number 5519 Estimate Number 1 Payment Number 1 For Period Ending City Secretary Contract Number Contract Date Project Manager NA Contractor BURNSCO CONSTRUCTION, INC. 6331 SOUTHWEST BLVD FORT WORTH � TX 76132 Inspectors T. GARDNER / J. ROGERS Contract Time Days Charged to Date Contract is 100.00 1 /7/2026 WD 40 WD 20 Complete Thursday, January 22, 2026 Page 1 of 4 City Project Numbers 105519 Contract Name NORTH SIDE PRESSURE PLANE 2.5 Contract Limits Project Type WATER Project Funding DOE Number 5519 Estimate Number 1 Payment Number 1 For Period Ending 1/7/2026 UNIT L• WATER IMPROVEMENTS Item No. 1 2 3 4 5 Description of Items Estimated Unit Quanity 16" DII' WATER 56 LF 16" GATE VALVE W/ VAULT 1 EA CONNECTION TO EXISTING 16" WATER MAIN 2 EA TRENCHSAFETY 56 LF DUCTILE IRON WATER FITTINGS W/ 1 TN Unit Cost �stimated Completed Completed Total Quanity Total $650.00 $36,400.00 56 $36,400.00 $44,000.00 $44,000.00 1 $44,000.00 S18,000.00 $36,000.00 2 $36,000.00 $15.00 $840.00 56 $840.00 $20,000.00 $20,000.00 1 $20,000.00 6 7 8 9 RESTRAINT PRESSURE SUSTAINING VALVE VAULT, ALL 1 EA FITTINGS, PIPING, VALVE AND OTHER PRESSURE SUSTAINING VALVE VAULT 1 EA SILT FENCE 105 LF Add A NEW 16" GAATE VALVE (CO#1) 2 EA Sub-Total of Previous Unit $297,560.00 �297,560.00 $145,580.00 � 145,580.00 $3.00 $315.00 $21,100.00 $42,200.00 $622,895.00 1 $297,560.00 1 $145,580.00 105 $315.00 2 $42,200.00 $622,895.00 Thursday, January 22, 2026 Page 2 of 4 City Project Numbers 105519 Contract Name NORTH SIDE PRESSURE PLANE 2.5 Contract Limits Project Type WATER Project Funding Contract Information Summary Original Contract Amount ChangC OYfleYS Change Order Number 1 Total Contract Price DOE Number 5519 Estimate Number 1 Payment Number 1 For Period Ending 1/7/2026 $580,695.00 $42,200.00 $622,895.00 Total Cost of Work Completed $622,895.00 Less % Retained $0.00 Net Earned $622,895.00 Earned This Period �622,895.00 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 $622,895.00 Thursday, January 22, 2026 Page 3 of 4 City Project Numbers 105519 Contract Name NORTH SIDE PRESSURE PLANE 2.5 Contract Limits Project Type WATER Project Funding Project Manager NA Inspectors T. GARDNER / J. ROGERS ContraCtor BURNSCO CONSTRUCTION, INC. 6331 SOUTHWEST BLVD FORT WORTH � TX 76132 DOE Number 5519 Estimate Number 1 Payment Number 1 For Period Ending 1/7/2026 City Secretary Contract Number Contract Date Contract Time Days Charged to Date CITY OF FORT WORTH SUMMARY OF CHARGES Line Fund Account Center 40 WD 20 WD Amount Gross Retainage Net Funded Total Cost of Work Completed Less % Retained Net Earned Earned This Period $622,895.00 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 $622,895.00 $0.00 $622,895.00 $0.00 $0.00 $0.00 $0.00 $0.00 $622,895.00 Thursday, January 22, 2026 Page 4 of 4 Docusign Envelope ID: 6F140E8E-2FE3-40D2-BECO-A482A9D808D7 CSC No. 62975-CO1 DEVELOPER-AWARDED-PROJECT CHANGE ORDER PROJECT NAME: CONTRACT: CFA # CITY PROJECT # CITY SECRETARY CONTRACT # FID # X# FILE # INSPECTOR: PROJECT MANAGER: North Side Pressure Plane 2.5 Water 24-0177 I 105519 62975 30114-0200431-105519-E07685 28151 N/A Eric Tinner Izeldeen Ahmed, P.E. CITY PARTICIPATION:I YES Phone No: Phone No: 817-392-7830 CHANGE ORDER No: 1 CONTRACT UNIT WATER SEWER DRAINAGE PAVING STREET LIGHTS Developer Developer Developer Developer Cost City Cost Developer Cost City Cost Cost City Cost Cost City Cost Cost City Cost ORIGINAL CONTRACT $19,395.21 $561,299.79 $0.00 $0.00 I $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 EXTRAS TO DATE $0.00 $0.00 $0.00 $0.00 I $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 CREDITS TO DATE $0.00 $0.00 $0.00 $0.00 I $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 CONTRACT TO DATE $19,395.21 $561,299.79 $0.00 $0.00 I $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 AMOUNT OF PROP. CHANGE ORDER $1,409.48 $40,790.52 $0.00 $0.00 I $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 REVISED CONTRACT AMOUNT $20,804.69 $602,090.31 $0.00 $0.00 I $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 TOTAL REVISED CONTRACT AMOUNT PER UNIT $622,895.00 $0.00 $0.00 $0.00 $0.00 REVISED COST SHARE Dev. Cost: $20,804.69 City Cost: $602,090.31 TOTAL REVISED CONTRACT $622,895.00 CONTRACT DAYS 40 40 0 40 Revised: 12-17-2018 Page 1 Docusign Envelope ID: 6F140E8E-2FE3-40D2-BECO-A482A9D808D7 You are directed to make the following changes in the contract documents: UNIT I: WATER IMPROVEMENTS CITY BID ITEM PAY ITEM # # QUANTITY UNIT ITEM DESCRIPTION `9 3312.3006 2.00 EA Add a new 16" Gate Valve PAY ITEM # � Asterisk (*) indicates New Pay Item CFW Unit Price TOTAL UNIT I: WATER IMPROVEMENTS � � � � � UNIT II: SANITARY SEWER IMPROVEMENTS CITY BID ITEM # QUANTITY UNIT ITEM DESCRIPTION TOTAL UNIT II: SANITARY SEWER IMPROVEMENTS Developer UNIT PRICE Cost City Cost TOTAL $21,100.00 $1,409.48 $40,790.52 $42,200.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $o.00 $o.00 $o.00 $o.00 $o.00 $o.00 $o.00 $o.00 $o.00 $o.00 $o.00 $o.00 $o.00 $o.00 $o.00 $o.00 $o.00 $o.00 $o.00 $o.00 $o.00 $o.00 $o.00 $o.00 $o.00 $o.00 $o.00 $o.00 $o.00 $o.00 $o.00 $o.00 1409.48 $40,790.52 $42,200.00 � � � � Developer UNIT PRICE Cost City Cost TOTAL $o.00 $o.00 $o.00 $o.00 $o.00 $o.00 $o.00 $o.00 $o.00 $o.00 $o.00 $o.00 $o.00 $o.00 $o.00 $o.00 $o.00 $o.00 $o.00 $o.00 $o.00 $o.00 $o.00 $o.ao $o.00 $o.ao $o.00 $o.ao o.00 o $0.00 � � Revised: 12-17-2018 Page 2 REASONSFOR CHANGE ORDER Adcfrt�oria+ �s��re� care ;:a?�;�es added to �+�e ;;o��i�act �e� c;tY of Fo�Y bVort+�'s request. Cr�anges cor,�es,00.��d !o Re�.�rso�� PJa � as s�7o�,^rra on sr�eet G of tlie co,��sir;ci�o�� a+ar�s. Signatu re: EmaiL• allison.tidwell(a�fortworthtexas.gov RECOMMENDED: S�c�ned hy; JH Eng�n2er nc. Inc. Qtrt.�.V�w �ia.� By � =.==✓r,_:.-_:_.iy Name: Andrew Kubiak, P_E. Title: Project P�lanager APPROVED: S ned rG i'° �i�" (`Q�A� _ y'I�3F2 G�Oi/,a 1�7C %� -_;�� r' ` ''a'- - B�': - '2D9cC551C754d8 Name: Stephen Brim r:tie= Vice President APPROVAL RECOMMENDED: APPROVED: CFW - Warer C7eparirnen; CFtN - Assrsta��t C;ry I�Ianayer Q�a� � x_ � � B �� r`j B _`� � '-�' ` Y� '' Y= �/ 11 06 2025 '�'� — %�:Yl Name: Subv Varuqhese. P.E- I � Name: Jesica L. P,9cEachem "��^ '"" ``.."" S 1�05�. Tltie Engineering P.9anger T:t�e: assr �:,�tv r.��,n�r RECOMMENDED: L'FW -'Co; itract Cor,�a��ance P;'i.�+�age� ATTEST ' Y�� .�a�� F'.:_" Jannette S. o9�a��Ys9�edeY,a��e��es gy. �ooda�� Goodall oa�ezozs,zo,o�oo:,a-�oa Name: Izeldeen Ahmed. P E 11IO3I2O2 Jannette S. Goodall ;,�ir,� sEcretani 11/25/2025 Title: Senior Professional En�in22r h,1&C Nwnb2r. N,'A P,�18z� Uate Approved: N;A � � 11/24/2025 APPROVED: 5lgned by: B;i;"r) CO CG+?Stt�ilCtfOl1 1.'TC. Q� � �.fi�..s B� �HUOULSOJ',1�.1H�tiOL Name: Ab Grantges r�ue_ Vice President APPROVED AS TO FORM AND LEGALITY: CF W- Assrstan[ City Artorney , Br�= � Name: Richard A h�lcCracken 11�17�2�2� Title: Sr Asst City Attny Sect Cl�ief " Contract Compliance Manager (Project Manager): 6y signing I acknowletlge tnat I am tne person responslble for the monitoring and administr�tion of this contract, indude ensuring all performance and reporting requirements. ❑There are NO City Funds associat�d vdith thfs Contract UThere are Cit�� Funds associated N,�ith this Contract Revised: 12-17-2018 Page 3 FORTWORTH TRANSPORTATION AND PUBLIC WORKS PIPE REPORT FOR: PROJECT NAME: NorthSide Pressure Plane 2.5 CITY PROJECT NUMBER: 105519 � WATER PIPE LAID SIZE TYPE OF PIPE Open Trench 16" DIP FIRE HYDRANTS: N/A PIPE ABANDONED N/A SIZE VALVES (16" OR LARGER) TYPE OF PIPE DENSITIES: NEW SERVICES: � PIPE LAID N/A N/A PIPE ABANDONED N/A DENSITIES: NEW SERVICES: f.y Y/I �I SIZE Passed N/A SEWER TYPE OF PIPE TYPE OF PIPE N/A N/A LF LF LF LF 56 3 TRANSPORTATION AND PUBLIC WORKS The City of Fort Worth • 1000 Throckmorton Street • Fort Worth, TX 76012-6311 (817) 392 - 7941 • Fax: (817) 392 - 7845 �`o�� rx� TRANSPORTATION AND PUBLIC WORKS January 8, 2026 Burnsco Constructiopn,lnc 6331 Southwest Blvd. Benbrook,TX 76132 RE: Acceptance Letter Project Name: North Side Pressure Plane 2.5 Project Type: Water City Project No.: 105519 To Whom It May Concern: On January 9, 2026 a final inspection was made on the subject project. There were no punch list items identified at that time. The final inspection indicates that the work meets the City of Fort Worth specifications and is therefore accepted by the City. The warranty period will start on January 9, 2026, which is the date of the final inspection and will extend of two (2) years in accordance with the Contract Documents. If you have any questions concerning this letter of acceptance, please feel free to contact me at 817.392.7830. Sincerely, a��.��e P� Izeldeen Ahmed P.E., Project Manager Cc: John Rogers, Inspector Gardner,Troy, Inspection Supervisor Hayes, Charles, Senior Inspector Andrew Goodman , Program Manager UA Engineering,lnc , Consultant Burnsco Constructiopn,lnc, Contractor Forestar (USA) Real Estate Group Inc., Developer File E-Mail: TPW_Acceptance@fortworthtexas.gov Rev. 08/20/19 AFFIDAVIT STATE OF TEXAS COUNTY OF TARRANT Before me, the undersiglied authority, a notary public in the state and county aforesaid, on this day personally appeared Ab Grantges, Cantract Mgr, Of Bui-nsco Constiliction, known to me to be a eredible person, wl3o Ueing by me duly sworn, upon his aath deposed and said; That a�l persons, f rms, associations, corporations, or other organizations fuz-nishing labor andlor materials have been paid in full; Tliat the wage scale ��tablished by the City Council in the City of Fort Worth has been paid in full; That there are no claians pending for persanal injury and/or property damages; On Contract described as; Northside Pressure Plane 2.5 : � Ab Gran � s, Vice President Subscribed ai�d sworn befor� ine on this date 3rd of February, 2026. �� Notary Public Tarrant County, Texas `\��,CRA� A��fi �7'F�,f � •..e.� r / .` �y.Q' . P\ B 'Q � ��: o�P Y PU ��c .s _ � _ : � � � � •'•.�%p � �f ��g .' : � �i •. �' 1332�;b .• r,� . ,��!�fF'�plRES &��-��. fd{�If#Iii11S11\ CONSENT OF owrv�� ❑ SURETY COMPANY ARCHITECT ❑ CONTRACTOR ❑ TO FINAL PAYMENT SURETY ❑ Conforms with the American Institute of OTHER Architects, AIA Document G707 PROJECT; (name, BdCifeSS)North Side Pressure Plane 2.5 - Water Improvements TO (Ownerl Arlington TX 76006 Fort Worth. TX Bond No 022241987 FORESTAR USA) REAL ESTATE GROUP INC. AND`I ARCHITECT'S PROJECT N0: THE CITY O� FORT WORTH CONTRACT FOR: 2221 E. Lamar Blvd., Suite 790 North Side Pressure Plane 2.5 - Water Improvements CONTRAC70R: BURNSCO CONSTRUCTION, INC. .� CONTRACT DATE: In accordance with the provisions of the Contract between the Owner and the Contractor as indicated above, the (here insert nama end address of Surety Companyl LIBERTY MUTUAL FIRE INSURANCE COMPANY 175 Berkeley Street Boston MA 02116 , SURETY COMPANY on bond of (here insert neme end address of Contractor) BURNSCO CONSTRUCTION, INC. 6331 Southwest Boulevard Benbrook TX 76132 , CONTRACTOR, hereby approves of the final payment to the Contractor, and agrees that final payment to the Contractor shall not relieve the Surety Company of any of its obligations to (here insert name and address ot Owner) FORESTAR (USA) REAL ESTA7E GROUP INC. AND THE CITY OF FORT WORTH 2221 E. Lamar Bivd., Suite 790 Arlington TX 76006 , OWNER, as set forth in the said Surety Company's ba�d. IN WITNESS, WHEREOF, the Surety Company has hereunto set its hand this Attest: (Seal): ��.x- i1 lc ��.,,��,,�_ 13th day of January, 2026 LIBERTY MUTUAL FIRE INSURANCE COMPANY Surety Company �{'i�-u l lu1"i�"r Signatu�e of Authorized Representative Soohinie Hunter Title Attorney-in-Fact NOTE: This form is io be used as a companion document to AIA DOCUMENT G706, CONTRACTOR'S AFFIDAVIT OF PAYMENT OF DEBTS AND CLAIMS, Current Edition ONE PAGE wr r� ti�1�I� � . �� POWER OF ATTORNEY Liberty Mutual Fire Insurance Company Wausau, Wisconsin Certificate No: 8213588-022020 KNOWN ALL PERSONS BY THESE PRESENTS: Liberty Mutual Fire Insurance Company, being a Wsconsin Corporation having its principal office in the City of Wausau, State of Wisconsin does hereby make, Constitute antl appoint Don E. Cornell; Sophinie Hunter; 'Cina McEwan; Kobbi Morales; Mikaela Peppers; "Tonie Petranek; Ricardo J. Reyna; Joshua Saunders; Kelly A. Westbrook all of the city of Dallas state of TX each individually if there be more than one nametl, its true antl lawful attorney(s)-in-fact, with full power and authority hereby conferred in their/its name, place and stead, to sign, execute, acknowledge and tleliver in their/its behalf, and as their/its act and deed, without power of redelegation, as follows: Bonds, undertakings, recognizances, contracts of indemnity, and all other surety obligations, as required, unlimited as to Dollar amount and to bind the Company(ies) making this appointment thereby as fully and to the same extent as if such bond or undertaking was signed by the duly authorized officers of the Company(ies), and all the acts of said attorney(s), pursuant to the authority herein given, are hereby ratifed and confirmed. ��, AUTHORITY FOR MAKING APPOINTMENT OF ATTORNEYS-IN-FACT I Appointment of Attorneys-in•Fact by Liberty Mutual Fire Insurance Company are made pursuant to Article V, Section 10 of Liberty Mutual Fire Insurance Company's By-Laws, as I amended and by Unanimous Consent of the Board of Directors datetl May 21st, 2013. Further, the Presitlent of Liberty Mutual Fire Insurance Company, executed a Delegation of i � �Authority and authorized the assistant secretary signing below to appoint attomeys-in-fact as may be necessary to act on behalf of Liberty Mutual Fire Insurance Company to make N�� , execute, seal, acknowledge and deliver as surety any and all undertakings, bonds, recognizances, and other surety obligations. � o � IN WITNESS WHEREOF, Liberty Mutual Fire Insurance Company has causetl these presents to be signed by its authorizetl representatives, and its Corporate Seal to be hereto affixed, _� I� � this 2nd day of April , 2025 . •— � a>�I o� �� Liberty Mutual Fire Insurance Company '� �, .�. � F�RE INS U � 0— � avoq G'F i' / � I � � tiP?�� Ta9n / � ' _ �, � � �19os o ��(�, L ---. .. �� Yd �'ScoNs`� a By� ._ - �� (n o'� �'s,� *�,�d Nathan J. Zangerle, Assistant Secretary � O � L � � � � C � O � O � I � � attest: �Cl�i1RJ1-'� `�Q.�'Q��- ¢ o �� Heather B. Magee o 0 � a� State of PENNSYLVANIA °' oNo �.� County of MONTGOMERY ss a� o� The foregoing instrument was acknowledged before me this 2nd day of April , 2025 by Nathan J. Zangerle, an authorized representative of Liberty Mutual Fire Insurance � o � � Insurance Company. '� � m— — U � (a C '6 V �� .� r Commonwealth of Pennsylvania - Notary Seai p� O� � 'e£ Teresa Pasteila, Notary Public �; ///� �� z U � '� � Montgomery County (/,/ ,� ' " 1 /� ��jpA � '�� ' " a My commission expires March 28, 2D29 B %�..�.(,a-pe.� /L{„�I..LC�( t.yt� �� Commission number 1126044 y� �� '` a�m.., -��>- f� � Member, Pennsylvania Association of Notaries Teresa Pastella, Notary Public �.0 � - r CERTIFICATE I, the undersigned, an Assistant Secretary of Liberty Mutual Fire Insurance Company, do hereby certify that the original power of attorney of which the foregoing is a full, true and correct copy, is in full force and effect on the date of this certificate; and I do further certify that the offcer or official who executed the said power of attorney was one of the officers or officials specially authorized by the Board of Directors to appoint attorneys-in-fact as provided in the Unanimous Consent and Vote of the Board of Directors of Liberty Mutual Fire Insurance Company dated May 21, 2013. This certificate and the above power of attorney may be signed by facsimile or mechanically reproduced signatures under and by authority of the Boartl of Directors of Liberty Mutual Fire Insurance Company evidenced by the Unanimous Consent and Vote of the Board of Directors dated June 28, 2006 wherein it was VOTED that the signatures of such officers and the seal of the Company may be affixed to any such power of attorney or to ariy certificate relating thereto by facsimile, antl any such power of attorney or certifcate bearing such facsimile signature and facsimile seal shall be valid and binding upon the Company when so affixed and in the future with respect to any surety undertakings, bonds, recognizances and other surety obligations to which it is attached. IN TESTIMONY WHEREOF, I have hereunto subscribed my name and affxed the corporate seal of the said company, affixed, this 13di day of .fanuary , 202( . LMS-22023 02/24 F�µH INgG tiJP?�oaPOR4Fq9n � C..G'N'�'7"."' � 19�go n By� .. ,. o Renee C. Llewellyn, Assistant Secretary ~d' ��SCONS�� a� �ej� * *Nd � � � ��'�r . � � ;r TEXAS IMPORTANT NOTICE To obtain information or make a complaint: You may call toll-free for information or to make a complaint at 1-877-751-2640 You may also write to: 2200 Renaissance Blvd., Ste. 400 King of Prussia, PA 19406-2755 You may contact the Texas Department of Insurance to obtain information on companies, coverages, rights or complaints at 1-800-252-3439 You may write the Texas Department of Insurance Consumer Protection (l l 1-lA) P. O. Box 149091 Austin, TX 78714-9091 FAX: (512) 490-1007 Web: httn://www.tdi.texas.gov E-mail: ConsumerProtectionn,tdi.texas.�ov PREMIUM OR CLAIM DISPUTES: Should you have a dispute concerning your pt•emium or about a claim you should first contact the agent or call 1-800-843-6446. If the dispute is not resolved, you may contact the Texas Deparhnent of Insurance. ATTACH THIS NOTICE TO YOUR POLICY: This notice is for inforination only and does not become a part or condition of the attached document. NP 70 68 09 01 LMS-15292 10/15 TEXAS AVISO IMPORTANTE Para obtener informacion o para someter una queja: Usted puede llamar al numero de telefono gratis para informacion o para someter una queja al 1-877-751-2640 Usted tambien puede escribir a: 2200 Renaissance Blvd., Ste. 400 King of Prussia, PA 19406-2755 Puede comunicarse con el Departamento de Seguros de Texas para obtener informacion acerca de companias, coberturas, det•echos o quejas al 1-800-252-3439 Puede escribir al Departamento de Seguros de Texas Consumer Protection ( i l l-1 A) P. O. Box 149091 Austin, TX 78714-9091 FAX # (512) 490-1007 Web: http://www.tdi.texas.eov E-mail: ConsumerProtection�,tdi.texas.�ov DISPUTAS SOBRE PRIMAS O RECLAMOS: Si tiena una disputa concerniente a su prima o a un reclamo, debe comunicarse con el agente o primero. Si no se resuelve la disputa, puede entonces comunicarse con el departamento (TDl) UNA ESTE AVISO A SU POLIZA: Este aviso es solo para proposito de informacion y no se convierte en parte o condicion del documento adjunto.