HomeMy WebLinkAbout062635-FP2 - Construction-Related - Contract - SEDALCO Construction Services-FP2
City Secretary 62635
Contract No.
FORT WORTH
Date Received 5/l /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: FWISD Forest Oak Middle School Addition
City Project No.: 105753
Improvement Type(s): Water ❑x Sewer ❑x
Original Contract Price:
$128,395.00
Amount of Approved Change Order(s):
$16,337.50
Revised Contract Amount:
$144,732.50
Total Cost of Work Complete:
$144,732.50
112� ��
Chad Martin IAor 31 2021181L00 .,DTI
Contractor
Project Manger
Title
SEDALCO Construction Services
Company Name
Project Inspector
Pro
ject Manager
CFA Manager
Lauren PrieurWav 1. 2026 13:49:41 CDT)
TPW Director
04/30/2026
Date
05/01 /2026
Date
05/01 /2026
Date
05/01 /2026
Date
05/01 /2026
Date
OFFICIAL RECORD
CITY SECRETARY
FT. WORTH, TX Page 1 of 2
Notice of Project Completion
Project Name: FWISD Forest Oak Middle School Addition
City Project No.: 105753
City's Attachments
Final Pay Estimate ❑x
Change Order(s): ❑x Yes ❑ N/A
Pipe Report: ❑x Yes ❑ N/A
Contractor's Attachments
Affidavit of Bills Paid
Consent of Surety
Statement of Contract Time
Contract Time: 75 WD Days Charged: 157 WD
Work Start Date: 5/27/2025 Work Complete Date: 2/5/2026
Completed number of Soil Lab Test: 217
Completed number of Water Test: 3
Page 2 of 2
FORT WORTH
CITY OF FORT WORTH
FINAL PAYMENT REQUEST
Contract Name FWISD FOREST OAK MIDDLE SCHOOL
Contract Limits
Project Type WATER & SEWER
City Project Numbers 105753
DOE Number 5753
Estimate Number I Payment Number I For Period Ending
City Secretary Contract Number
Contract Date
Project Manager NA
Contractor SEDALCO CONSTRUCTION SERVICES
4100 FOSSIL CREEK BLVD
FORT WORTH, TX 76137
Inspectors D. WATSON / S. QUINONES
Contract Time
Days Charged to Date
Contract is 100.00
2/5/2026
WD
7WD
157
Complete
Thursday, April 9, 2026 Page 1 of 5
City Project Numbers 105753
Contract Name FWISD FOREST OAK MIDDLE SCHOOL
Contract Limits
Project Type WATER & SEWER
Project Funding
UNTI' I: WATER IMPROVEMENTS
Item Description of Items
No.
---------------
1 SALVAGE 2" WATER METER
2 6' WIDE ASPHALT PVMT REPAIR,
RESIDENTIAL
3 ASPHALT PVMT REPAIR, WATER SERVICE
4 UTILITY SERVICE SURFACE RESTORATION
SODDING
5 TRENCH SAFETY SAFETY
6 6" WATER CARRIER PIPE
7 DUCTILE IRON WATER FITTINGS W/
RESITANT (CO#2)
8 8" PVC WATER PIPE (CO#2)
9 12" PVC WATER PIPE
10 CONNECTION TO EXISTING 4"-12" WATER
MAIN
DOE Number 5753
Estimate Number 1
Payment Number I
For Period Ending 2/5/2026
Estimated Unit
Unit Cost
Estimated
Completed
Completed
Quanity
Total
Quanity
Total
------------------------
1 EA
$800.00
$800.00
1
$800.00
252 LF
$15.00
$3,780.00
252
$3,780.00
2784 SF
$5.00
$13,920.00
2784
$13,920.00
6 SY
$150.00
$900.00
6
$900.00
50 LF
$30.00
$1,500.00
50
$1,500.00
25 LF
$60.00
$1,500.00
25
$1,500.00
II EA
$800.00
$8,800.00
11
$8,800.00
232 LF
$80.00
$18,560.00
232
$18,560.00
15 LF
$68.00
$1,020.00
15
$1,020.00
7 EA
$1,800.00
$12,600.00
7
$12,600.00
11
1" WATER SERVICE (CO#2)
5 EA
$2,500.00
$12,500.00
5
$12,500.00
12
2" WATER SERVICE
2 EA
$3,200.00
$6,400.00
2
$6,400.00
13
6" GATE VALVE
I EA
$1,800.00
$1,800.00
1
$1,800.00
14
8" GATE VALVE
2 EA
$2,800.00
$5,600.00
2
$5,600.00
15
12" GATE VALVE
1 EA
$4,200.00
$4,200.00
1
$4,200.00
16
--------------------------------------
TRAFFIC CONTROL
3 MO
$1,200.00
$3,600.00
3
$3,600.00
Sub-Total of Previous Unit
$97,480.00
$97,480.00
UNIT It: SANITARY SEWER IMPROVEMENTS
Item Description of Items
No.
-----------------
1 REMOVE 8' SEWER LINE
2 REMOVE 4' SEWER MANHOLE
3 6' WIDE ASPHALT PVMT REPAIR,
RESUENTIAL
4 UTIL;TTY SERVICE SURFACE RESTORATION
SODDING
5 POST -CCTV INSPECTION
6 MANHOLE VACUUM TESTING
Estimated Unit
Unit Cost
Estimated
Completed
Completed
Quanity
Total
Quanity
Total
----------------------
78 LF
$20.00
$1,560.00
78
$1,560.00
1 EA
$850.00
$850.00
1
$850.00
99 LF
$15.00
$1,485.00
99
$1,485.00
8 SY
$150.00
$1,200.00
8
$1,200.00
136 LF
$5.00
$680.00
136
$680.00
3 EA
$800.00
$2,400.00
3
$2,400.00
Thursday, April 9, 2026 Page 2 of 5
City Project Numbers 105753
Contract Name FWISD FOREST OAK MIDDLE SCHOOL
Contract Limits
Project Type WATER & SEWER
Project Funding
7
TRENCH SAFETY
105 LF
8
CONCRETE COLLAR FOR MANHOLE
2 EA
9
TRENCH WATER STOPS
1 EA
10
CONCRETE ENCASEMENT FOR UTILITY PIPES
18 CY
11
IMPORTED EMBEDMENT/BACKFILL, CLSM
15 CY
12
8" DIP SEWER PIPE
136 LF
13
EPDXY MANHOLE LINER (CO#1)
0 VF
14
4' MANHOLE
I EA
15
4' DROP MANHOLE
2 EA
16
4' EXTRA DEPTH MANHOLE
2 VF
17
TRAFFIC CONTROL
3 MO
18
EPDXY MANHOLE LINER (CO#1)
22 VF
Sub -Total of Previous
Unit
DOE Number 5753
Estimate Number 1
Payment Number I
For Period Ending 2/5/2026
$30.00
$3,150.00
105
$3,150.00
$800.00
$1,600.00
2
$1,600.00
$450.00
$450.00
1
$450.00
$130.00
$2,340.00
18
$2,340.00
$38.00
$570.00
15
$570.00
$80.00
$10,880.00
136
$10,880.00
$250.00
$0.00
0
$0.00
$4,800.00
$4,800.00
1
$4,800.00
$5,200.00
$10,400.00
2
$10,400.00
$300.00
$600.00
2
$600.00
$1,200.00
$3,600.00
3
$3,600.00
$31.25
------------
$687.50
22
$687.50
$47,252.50
$47,252.50
Thursday, April 9, 2026 Page 3 of 5
City Project Numbers 105753
Contract Name FWISD FOREST OAK MIDDLE SCHOOL
Contract Limits
Project Type WATER & SEWER
Project Funding
Contract Information Summary
Original Contract Amount
Change Orders
Change Order Number l
Change Order Number 2
Total Contract Price
DOE Number 5753
Estimate Number 1
Payment Number I
For Period Ending 2/5/2026
$128,395.00
($62.50)
$16,400.00
$144,732.50
Total Cost of Work Completed $144,732.50
Less % Retained $0.00
Net Earned $144,732.50
Earned This Period $144,732.50
Retainage This Period $0.00
Less Liquidated Damages
Days @ / Day
$0.00
LessPavement Deficiency
$0.00
Less Penalty
$0.00
Less Previous Payment
$0.00
Plus Material on Hand Less 15%
$0.00
Balance Due This Payment
$144,732.50
Thursday, April 9, 2026 Page 4 of 5
City Project Numbers 105753
Contract Name FWISD FOREST OAK MIDDLE SCHOOL
Contract Limits
Project Type WATER & SEWER
Project Funding
Project Manager NA
Inspectors D. WATSON / S. QUINONES
Contractor SEDALCO CONSTRUCTION SERVICES
4100 FOSSIL CREEK BLVD
FORT WORTH, TX 76137
DOE Number 5753
Estimate Number 1
Payment Number I
For Period Ending 2/5/2026
City Secretary Contract Number
Contract Date
Contract Time 75 WD
Days Charged to Date 157 WD
Contract is .000000 Complete
CITY OF FORT WORTH
SUMMARY OF CHARGES
Line Fund Account Center Amount Gross Retainage
Funded
Net
Total Cost of Work Completed $144,732.50
Less % Retained
$0.00
Net Earned
$144,732.50
Earned This Period $144,732.50
Retainage This Period $0.00
Less Liquidated Damages
0 Days @ $0.00 / Day
$0.00
LessPavement Deficiency
$0.00
Less Penalty
$0.00
Less Previous Payment
$0.00
Plus Material on Hand Less 15%
$0.00
Balance Due This Payment
$144,732.50
Thursday, April 9, 2026 Page 5 of 5
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REVEL PE -AWAR ED•PRO ECT QHANGE ORDrR
PROJECT NAME:
FWISO FOREST OAK MIDDLE SCHOOL ADDITIONIRENOVATION
CHANGE
CONTRACT
WATER, SEWER, PAVING AND DRAINAGE IMPROVEMENTS
ORDER No:
CFA#
24-0179 CITY PARTICIPATION: NO
CITY PROJECT #
105753
CITY SECRETARY CONTRACT #
62635
2
FID #
30114-02OD431-105753-E07685
x #
26320
FILE #
K-3313
INSPECTOR: Samuel Quinones Scott Phone No: 682-225-9106
PROJECT MANAGER: Sandip Adhikad Phone No: 682432-5559
CONTRACT UNIT
WORKING
DAYS
WATER I
SEWER
DRAINAGE
PAVING
STREETLIGHTS
Developer
Cost
CiM Cm1
Developer Cost
Cnty C-1
Developet
Cost
Ct1y Ca0
Cast
coy Cott
Ulm -,
Cast
I City Copt
ORIGINALCONTRACT
$51.080.00
$0.00
S47,315.00
SD.00
S0,432.00
50.00
$370.406.04
50.00
$0.00
ft1.0D
75
EXTRAS TO DATE
$0.00
$0.00
$0.00
SO.30
$0.00
$0.00
SO.00
59.00
$0.00
%oo
0
CREDITS TO DATE
$0.00
$0.00
$62.50
S0.00
$0.00
50.00
$0.00
30-00
SO.00
50.00
0
CONTRACT TO DATE
S81,0e0.00
$0,00
S47,252.50
$0.00
$8.432.00
SORG
$370,406.04
50.00
SO.00
$0.90
75
AMOUNT OF PROP CHANGE ORDER
$16,400.00
$0.00
So*"
50.00
$0.00
S J
SO.DD
S0.00
$0.00
SO.00
10
REVISED CONTRACT AMOUNT
$97,480.00
50.00
547,252.50
S0.0p
$0.432.00
$0-
f370.40b.04
50,00
$0400
$0600
85
TOTAL REVISED CONTRACT AMOUNT PER
UNIT
507,450.00
147.252.50
S8,432.0D
S370A06.04
$0.00
REVISED COST SHARE
Dev. Cost: $S23,570.64 City Cost: $0.00
TOTAL REVISED CONTRACT
$523,570.54
REVIEWED
By Sandip Adhikari at 4:11 pm, Dec 22, 2025
Revised: 12-17-2018
Page 1
You are directed to make the followvig changes in the contract documents
PAY ITEM
CITY BID ITEM
#
QUANTITY
lAVlt
I rE M DESCRIPTION
UNIT PRICE
Developer
Coo
City Coo
TOTAL
7
13 11 11
8
IeA
3311.0001 Ductile lien Water FAirgs wl Restraint
StIM00
Sa 800.00
$0.00
34.800.00
e
331112
20
lF
33110261 8"PVC Water Pipe
Sa0.00
SI.600.00
$000
51,60000
11
341210
4
EA
3312 2003 1" Water service
52500.00
;10,000.00
$0 00
510,000.00
Asterisk J•) indicates Now Pay Item
REVIEWED
By Sandip Adhikari at 4:11 pm, Dec 22, 2025
Revised: 12-17-2018 Page 2
REASONS FOR CHANGE ORDER
Bid quantity reconcile to match the construction plan. Changes correspond to Revision No. 2 and 3, sheet 7.1, B, and 9.1 in Construction Plans.
RECOMMENDED: APPROVED: APPROVED:
JQ Inirastructwfi. LLC Fan Wogh Independent School District SEDALC,9 / Al
Date, 12/11/2025
Name.: Owd4 M. Sipoa. PE
Title: Engineer of Record
Date 12/16/2025
Name: Kellie Spencer Name: Chad Martin
FWISD Deputy Superintendent of
Title: Datnet OLmwions Title: Project Manager
APPROVAL RECOMMENDED: APPROVED: APPROVED AS TO FORM AN13 LEGALITY:
CFW - Water Department CFW - Assistant City Manager CFW - Assistant City Attorney
By Not Applicable Dale: By Not Applicable Dale: By: Not Applicable Date
Name: Not Applicable Name: Not Applicable Name: Not Applicable
Title: Not Applicable Tllle: Not Applicable Title: Not Applicable
RECOMMENDED:
12/11 /2025
CFW-'Contract Compliance Manager ATTEST • Contract Compliance Manager (Project Manager(:
By signing I acknowledge that I am the person responsible
By: Dale: for the monitoring and administration of this contract,
By Not Applicable Date: and ensuring all performance and reporting requirements.
Name:
Name: Jannette S. Goodall ° There are NO City Funds associated with this Contract
Title:
Title; City Secretary ° There are City Funds associated with this Contract
lo
REVIEWED
M&C Number. N/A By Sandip Adhikari at 4:11 pm, Dec 22, 2025
M&C Dale Approved: N/A
Revised: 12-17-201 B Page 3
FORT WORTH
TRANSPORTATION AND PUBLIC WORKS
PIPE REPORT FOR:
PROJECT NAME: FWISD Forest Oak Middle School Addition
CITY PROJECT NUMBER: 105753
WATER
PIPE LAID
SIZE
TYPE OF PIPE
LF
Open Trench
12"
PVC Water Pipe
15'
Open Trench
8"
PVC Water Pipe
232'
Open Trench
6"
PVC Water Pipe
25'
FIRE HYDRANTS: n/a
VALVES (16" OR LARGER)
PIPE ABANDONED
SIZE
TYPE OF PIPE
LF
DENSITIES:
TAKEN: Passed
NEW SERVICES:
I"
Copper DOM
75'
2"
Copper DOM
30'
SEWER
PIPE LAID
SIZE
TYPE OF PIPE
LF
Open Trench
8"
Sewer DIP
136
PIPE ABANDONED
SIZE
TYPE OF PIPE
LF
DENSITIES:
TAKEN: Passed
NEW SERVICES:
TRANSPORTATION AND PUBLIC WORKS
The City of Fort Worth • 1000 Throckmorton Street • Fort Worth, TX 76012-6311
(817) 392 - 7941 • Fax: (817) 392 - 7845
FORTWORTH.
TRANSPORTATION AND PUBLIC WORKS
April 9, 2026
Sedalco Construction Services
4100 Fossil Creek Blvd.
Fort Worth, Tx 76136
RE: Acceptance Letter
Project Name: FWISD FOREST OAK MIDDLE SCHOOL ADDITION/RENOVATION
Project Type: Water, Sewer
City Project No.: 105753
To Whom It May Concern:
On March 4, 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 April 7, 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 April 7, 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-
392-8424.
Sincerely,
-011,11-
Sandip Adhikari, Project Manager
Cc: Sergio Garcia, Inspector
Cody Horton, Inspection Supervisor
Oscar Aguillon, Senior Inspector
Andrew Goodman, Program Manager
JQ Civil Engineering 7986, Consultant
Seldaco Construction Services, Contractor
Fort Worth Independent School District, Developer
File
E-Mail: TPW_Acceptance@fortworthtexas.gov
Rev. 8/20/19
AFFIDAVIT
STATE OF Texas
COUNTY OF Tarrant
Before me, the undersigned authority, a notary public in the state
and county aforesaid, on this day personally appeared Chad Martin,
Project Manager Of SEDALCO, Inc, 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;
FWISD FOREST OAK M.S. - PUBLIC WORK AMENDMENT
BY Chad Martin Digitally signed by Chad Martin
Date: 2026.04.29 08:24:43-05'00'
Chad Martin, Project Manager
Subscribed and sworn before me on this date 28th of April, 2026.
f kWl �•��fC �
Notary Public
Tarrant, Texas
KIM VAUGHAN
Notary Public • : * ` STATE OF TEXAS
t ID * 132a6C Q
Consent of Surety
OWNER
❑
to Final Payment
ARCHITECT
❑
CONTRACTOR
❑
SURETY
AIA DOCUMENT G707
OTHER
❑
Bond No. 30236439
TO OWNER: ARCHITECT'S PROJECT NO.:
(Name and address)
City of Fort Worth CONTRACT FOR: Construction
100 Fort Worth Trail
Fort Worth, TX 76102
PROJECT: FWISD Forest Oak Middle School Addition CFA
(Name and address)
CONTRACT DATED:
In accordance with the provisions of the Contract between the Owner and the Contractor as included above, the
National Fire Insurance Company of Hartford
151 N. Franklin Street, Chicago, IL 60606
(insert name and address of Surety)
SURETY, on bond of SEDALCO-POST L, A Joint Venture
(Insert name and address of contractor)
4100 Fossil Creek Blvd., Fort Worth, TX 76137 'CONTRACTOR,
hereby approves of the final payment to the Contractor, and agrees that final payment to the Contractor shall not relieve the
Surety of any of its obligations to City of Fort Worth
(Insert name and address of Owner)
100 Fort Worth Trail, Fort Worth, TX 76102
as set forth in the said Surety's bond.
• ■C TAMi,t::�
IN WITNESS WHEREOF, the Surety has hereunto set its hand on this date: -April 24 2026
(Insert in wrd°ing the month followed by the numeric date and year.)
Attest:
(Seal):^
National Fire Insurance Company of Hartford
{Su }
(Si tore of authorized sentativej
Amber Jones, Attorney -in -Fact
(Printed name and title
Printed in cooperation with the American Institute of Architects (AIA)
The language in this document conforms exactly to the language used in AIA Document G707 - Consent of Surety Company to Final Payment -
1994 Edition.
POWER OF ATTORNEY APPOINTING INDIVIDUAL ATTORNEY -IN -FACT
Know All Men By These Presents, That Continental Casualty Company, an Illinois insurance company, National Fire Insurance Company of Hartford, an
Illinois insurance company, and American Casualty Company of Reading, Pennsylvania, a Pennsylvania insurance company (herein called "the CNA Companies"), are
duly organized and existing insurance companies having their principal offices in the City of Chicago, and State of Illinois, and that they do by virtue of the signatures
and seals herein affixed hereby make, constitute and appoint
Darrin Weber, Amber Jones, April Penny, Julie Baumberger, Evelyn Marie Henson
, Individually
of Dallas, TX, their true and lawful Attomey(s)-in-Fact with full power and authority hereby conferred to sign, seal and execute for and on their behalf bonds,
undertakings and other obligatory instruments of similar nature
In Unlimited Amounts -
and to bind them thereby as fully and to the same extent as if such instruments were signed by a duly authorized officer of their insurance companies and all the acts of
said Attorney, pursuant to the authority hereby given is hereby ratified and confirmed.
This Power of Attorney is made and executed pursuant to and by authority of the By -Laws and Resolutions, printed below, duly adopted, as indicated, by the
Boards of Directors of the insurance companies.
In Witness Whereof, the CNA Companies have caused these presents to be signed by their Vice President and their corporate seals to be hereto affixed on this
25th day of February, 2026.
Continental Casualty Company
tNStIR�d"' a0 National Fire Insurance Company of Hartford
pOPP�ArE, o ,MC��ItITtO American Casualty Company of Rcadin. Pennsylvania
2 ' s JU YY K
g�g . C�k
t8g7 Larry Kasten Vice President
State of South Dakota, County of Minnehaha, ss:
On this 25th day of February, 2026, before me personally came Larry Kasten to me known, who, being by me duly sworn, did depose and say: that he resides in
the City of Sioux Falls, State of South Dakota; that he is a Vice President of Continental Casualty Company, an Illinois insurance company, National Fire Insurance
Company of Hartford, an Illinois insurance company, and American Casualty Company of Reading, Pennsylvania, a Pennsylvania insurance company described in and
which executed the above instrument; that he knows the seals of said insurance companies; that the seals affixed to the said instrument are such corporate seals; that
they were so affixed pursuant to authority given by the Boards of Directors of said insurance companies and that he signed his name thereto pursuant to like authority,
and acknowledges same to be the act and deed of said insurance companies.
My commission expires WAIIHSOUTH °TA
December 4, 2031
K. Walsh Notary Public
CERTIFICATE
I, Paula Kolsrud, Assistant Secretary of Continental Casualty Company, an Illinois insurance company, National Fire Insurance Company of Hartford, an Illinois
insurance company, and American Casualty Company of Reading, Pennsylvania, a Pennsylvania insurance company do hereby certify that the Power of Attorney
herein above set forth is still in force, and further certify that the By -Laws and Resolutions of the Board of Directors of the insurance companies printed below are still
in force. In testimony whereof I have hereunto subscribed my name and affixed the seal of the said insurance companies this 24" day of April, 2026.
Continental Casualty Company
GSA( WSURq ��ppMroe� National Fire Insurance Company of Hartford
(�i~ American Casualty Company of Reading, Pennsylvania
2/ CoFtponAre
Z 2 A IULY !1.
PO $EAL t 190E
t8p7
Paula Kolsrud Assistant Secretary
Authorizing By -Laws and Resolutions
ADOPTED BY THE BOARD OF DIRECTORS OF EACH OF CONTINENTAL CASUALTY COMPANY, NATIONAL FIRE INSURANCE COMPANY OF
HARTFORD, and AMERICAN CASUALTY COMPANY OF READING, PENNSYLVANIA (as defined above, the "CNA Companies");
This Power of Attorney is made and executed pursuant to and by authority of the following resolution duly adopted by the Board of Directors of each of the above CNA
Companies at a meeting held on May 12, 1995:
"RESOLVED: That any Senior or Group Vice President may authorize an officer to sign specific documents, agreements and instruments on behalf of the Company
provided that the name of such authorized officer and a description of the documents, agreements or instruments that such officer may sign will be provided in
writing by the Senior or Group Vice President to the Secretary of the Company prior to such execution becoming effective."
This Power of Attorney is signed by Larry Kasten, Vice President, who has been authorized pursuant to the above resolution to execute power of attorneys on behalf
of each of the CNA Companies.
This Power of Attorney is signed and sealed by facsimile under and by the authority of the following Resolution adopted by the Board of Directors of each of the above
Companies by unanimous written consent dated the 25'h day of April, 2012:
"Whereas, the bylaws of the Company or specific resolution of the Board of Directors has authorized various officers (the "Authorized Officers") to execute various
policies, bonds, undertakings and other obligatory instruments of like nature; and
Whereas, from time to time, the signature of the Authorized Officers, in addition to being provided in original, hard copy format, may be provided via facsimile or
otherwise in an electronic format (collectively, "Electronic Signatures"); Now therefore be it resolved: that the Electronic Signature of any Authorized Officer shall
be valid and binding on the Company."
This Power of Attorney may be signed by digital signature and sealed by a digital or otherwise electronic -formatted corporate seal under and by the authority of the
following Resolution adopted by the Board of Directors of each of the above CNA Companies by unanimous written consent dated the 27th day of April, 2022:
"RESOLVED: That it is in the best interest of the Company to periodically ratify and confirm any corporate documents signed by digital signatures and to ratify
and confirm the use of a digital or otherwise electronic -formatted corporate seal, each to be considered the act and deed of the Company."
Go to www.cnasurety.com > Owner / Obligee Services > Validate Bond Coverage, if you want to verify bond authenticity.
Form F6653-6/2023
Figure: 28 TAC §1.601(a)(3)
1 IMPORTANT NOTICE
To obtain information or make a complaint:
2 You may contact Continental Casualty Company,
National Fire Insurance Company of Hartford,
American Casualty Company of Reading, PA and
Continental Insurance Company at 312-822-5000.
3 You may call Continental Casualty Company,
National Fire Insurance Company of Hartford,
American Casualty Company of Reading, PA and
Continental Insurance Company's toll -free telephone
number for information or to make a complaint at:
1-877-672-6115
4 You may also write to Continental Casualty
Company, National Fire Insurance Company of
Hartford, American Casualty Company of Reading,
PA and Continental Insurance Company at:
CNA Surety
151 North Franklin, 17th Floor
Chicago, IL 60606
5 You may contact the Texas Department of
Insurance to obtain information on companies,
coverages, rights or complaints at:
1-800-252-3439
6 You may write the Texas Department of
Insurance:
P.O. Box 149104
Austin, TX 78714-9104
Fax: (512) 490-1007
Web: www.tdi.texas.gov
E-Mail: ConsumerProtection@tdi.texas.gov
7 PREMIUM OR CLAIM DISPUTES:
Should you have a dispute concerning your
premium or about a claim you should contact
Continental Casualty Company, National Fire
Insurance Company of Hartford, American Casualty
Company of Reading, PA and Continental Insurance
Company first. If the dispute is not resolved, you
may contact the Texas Department of Insurance.
8 ATTACH THIS NOTICE TO YOUR POLICY
This notice is for information only and does not
become a part or condition of the attached
document.
Form F8277-6-2018
AVISO IMPORTANTE
Para obtener informacion o para someter una queja:
Puede comunicarse con Continental Casualty
Company, National Fire Insurance Company de
Hartford, American Casualty Company de Reading, PA
y Continental Insurance Company al 312-822-5000.
Usted puede Ilamar al numero de telefono gratis de
Continental Casualty Company, National Fire
Insurance Company de Hartford, American Casualty
Company de Reading, PA y Continental Insurance
Company's para informacion o para someter una
queja al:
1-877-672-6115
Usted tambien puede escribir a Continental Casualty
Company, National Fire Insurance Company de
Hartford, American Casualty Company de Reading,
PA y Continental Insurance Company:
CNA Surety
151 North Franklin, 17th Floor
Chicago, IL 60606
Puede comunicarse con el Departamento de Seguros
de Texas para obtener informacion acerca de
companias, coberturas, derechos o quejas al:
1-800-252-3439
Puede escribir al Departamento de Seguros de
Texas:
P.O. Box 149104
Austin, TX 78714-9104
Fax: (512) 490-1007
Web: www.tdi.texas.gov
E-Mail: ConsumerProtection@tdi.texas.gov
DISPUTAS SOBRE PRIMAS O RECLAMOS:
Si tiene .una disputa concerniente a su prima o a
un reclamo, debe comunicarse con el Continental
Casualty Company, National Fire Insurance
Company de Hartford, American Casualty Company
de Reading, PA y Continental Insurance Company
primero. Si no se resuelve la disputa, puede
entonces comunicarse con el departamento (TDI).
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.
State of Texas
Claim Notice Endorsement
To be attached to and form a part of Bond No. 30236439
In accordance with Section 2253.021(f) of the Texas Government Code and Section
53.202(6) of the Texas Property Code any notice of claim to the named surety under this
bond(s) should be sent to:
CNA Surety
161 North Franklin, 17th Floor
Chicago, IL 60606
Telephone: 1-877-672-6115
Form F6944-6-2018