HomeMy WebLinkAbout063344-FP1 - Construction-Related - Contract - MYCON General Contractors-FP1
City Secretary
Contract No. 63344
FORT WORTH.
Date Received 6/18/2026
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: BJ's Wholesale Club
City Project No.: 105635
Improvement Type(s): ❑x Paving ❑x Drainage ❑x Street Lights ❑x Traffic Signal
Original Contract Price:
$548,438.40
Amount of Approved Change Order(s):
$91,021.50
Revised Contract Amount:
$639,459.90
Total Cost of Work Complete:
$639,459.90
l ,.,-.. /3.1.-,
Jew_ Borhauu fJun 1C 2026 15III I-DT'DTI
Contractor
Sr. Project Manager
Title
MYCON General Contractors
Company Name
1)1-ti
Dana Carr (Jun 16. 2026 15:26:41 CDT
Project Inspector
4011
Ahmed Musa (Jun 17. 2026 13:49:16 CDTI
Project Manager
CFA Manager
de..,..7,.:.r,,.
Lauren Prieur (Jun 18. 2026 14:14:34 CDT)
TPW Director
06/16/2026
Date
06/16/2026
Date
06/17/2026
Date
06/18/2026
Date
06/18/2026
Date
OFFICIAL RECORD
CITY SECRETARY
FT. WORTH, TX
Page 1 of 2
Notice of Project Completion
Project Name: BJ's Wholesale Club
City Project No.: 105635
City's Attachments
Final Pay Estimate
Change Order(s): ® Yes ❑ N/A
Contractor's Attachments
Affidavit of Bills Paid
Consent of Surety
Statement of Contract Time
Contract Time: 183 WD Days Charged: 155 WD
Work Start Date: 9/9/2025 Work Complete Date: 5/26/2026
Completed number of Soil Lab Test: 254
Completed number of Water Test: 6
Page 2 of 2
FORT WORTH
CITY OF FORT WORTH
FINAL PAYMENT REQUEST
Contract Name BJ's WHOLESALE CLUB
Contract Limits
Project Type DRAINAGE, PAVING, STREETLIGHTS & TRAFFIC
City Project Numbers 105635
DOE Number 5636
Estimate Number I Payment Number I For Period Ending 5/26/2026
VVD
City Secretary Contract Number
Contract Date
Project Manager NA
Contractor MYCON GENERAL CONTRACTORS
208 E LOUISIANA STE 200
MCKINNEY, TX 75069
Inspectors G.DEYON / M.CAIN
Contract Time 183 WD
Days Charged to Date 155
Contract is 100.00 Complete
Tuesday, June 2, 2026 Page 1 of 5
City Project Numbers 105635 DOE Number 5636
Contract Name BJ's WHOLESALE CLUB Estimate Number 1
Contract Limits Payment Number I
Project Type DRAINAGE, PAVING, STREETLIGHTS & TRAFFIC For Period Ending 5/26/2026
Project Funding
UNIT IQ: DRAINAGE IMPROVEMENTS
Item
Description of Items
Estimated Unit
Unit Cost
Estimated
Completed
Completed
No.
Quanity
Total
Quanity
Total
---------------------------------------
1
42" RCP, CLASS ill
421 LF
$175.00
$73,675.00
421
$73,675.00
2
36" RCP, CLASS III
158 LF
$150.00
$23,700.00
158
$23,700.00
3
24" RCP, CLASS 111
115 LF
$110.00
$12,650.00
115
$12,650.00
4
CONCRETE RIPRAP
64 SY
$100.00
$6,400.00
64
$6,400.00
5
LARGE STONE RIPRAP, DRY
620 SY
$85.00
$52,700.00
620
$52,700.00
6
10' CURB INLET
2 EA
$4,500.00
$9,000.00
2
$9,000.00
7
--------------------------------------
POST -CCTV INSPECTION
694 LF
$2.25
$1,561.50
694
$1,561.50
Sub-Total
of Previous Unit
$179,686.50
$179,686.50
UNIT IV: PAVING IMPROVEMENTS
Item
Description of Items
Estimated Unit
Unit Cost
Estimated
Completed
Completed
No.
Quanity
Total
Quanity
Total
---------------------------------------
1
8" CONE PVMT
2864 SY
$9.60
$27,494.40
2864
$27,494.40
2
REMOVE SIDEWALK
594 SF
$5.00
$2,970.00
594
$2,970.00
3
REMOVE WALL > 4'
103 LF
$15.00
$1,545.00
103
$1,545.00
4
4" CONE SIDEWALK
260 SF
$5.80
$1,508.00
260
$1,508.00
5
BARRIER FREE RAMP, TYPE P-1
3 EA
$700.00
$2,100.00
3
$2,100.00
6
8" LIME TREATMENT
2864 SY
$7.50
$21,480.00
2864
$21,480.00
7
REMOVE CONC CURB&GUTTER
611 LF
$5.50
$3,360.50
611
$3,360.50
8
6" CONE CURB AND GUTTER
1989 LF
$21.00
$41,769.00
1989
$41,769.00
9
--------------------------------------
CONCRETE RETAINING WALL
198 SF
$394.25
$78,061.50
198
$78,061.50
Sub-Total
of Previous Unit
$180,288.40
$180,288.40
UNIT V: STREET LIGHTS IMPROVEMENTS
Item Description of Items
No.
-----------------
1 FURNISH/INSTALL RDWAY ILLUM TY 18 POLE
2 FURNISH/INSTALL TYPE 33A ARM
3 TY 3 SIGNAL FOUNDATION
4 RDWY ILLUM ASSMBLY TY 1,4, AND 6
5 2" CONDT PVC SCH 80 (T)
Estimated Unit
Unit Cost
Estimated
Completed
Completed
Quanity
Total
Quanity
Total
----------------------
5 EA
$5,691.00
$28,455.00
5
$28,455.00
8 EA
$915.00
$7,320.00
8
$7,320.00
5 EA
$6,622.00
$33,110.00
5
$33,110.00
8 EA
$4,341.00
$34,728.00
8
$34,728.00
436 LF
$39.00
$17,004.00
436
$17,004.00
Tuesday, June 2, 2026 Page 2 of 5
City Project Numbers 105635 DOE Number 5636
Contract Name BJ's WHOLESALE CLUB Estimate Number 1
Contract Limits Payment Number I
Project Type DRAINAGE, PAVING, STREETLIGHTS & TRAFFIC For Period Ending 5/26/2026
Project Funding
6 2" CONDT PVC SCH 80 (B)(CO#2) 638 LF $81.00 $51,678.00 638 $51,678.00
7 LUMINAIRE HEAD ATBO-P303-MVOLT-R2- 5 EA $1,138.00 $5,690.00 5 $5,690.00
3KMP-NL-P7-AO- RFD322792
--------------------------------------
Sub-Total of Previous Unit $177,985.00 $177,985.00
UNIT VI: TRAFFIC IMPROVEMENTS
Item
Description of Items
Estimated Unit
Unit Cost
Estimated
Completed
Completed
No.
Quanity
Total
Quanity
Total
1
FURNISH/INSTALL 5-SECT SIGNAL HEAD
1 EA
$7,100.00
$7,100.00
1
$7,100.00
ASSEMBLY
2
REMOVE SIGNAL HEAD ASSEMBLY
I EA
$150.00
$150.00
1
$150.00
3
FURNISH/INSTALL PED SIGNAL HEAD
4 EA
$1,839.00
$7,356.00
4
$7,356.00
ASSM 3LY
4
REMOVE PED SIGNAL HEAD ASSEMBLY
4 EA
$150.00
$600.00
4
$600.00
5
FURNISH/INSTALL BACKPLATE W/ REFL
I EA
$370.00
$370.00
1
$370.00
BRDR
6
FURNISH/INSTALL AUDIBLE PEDESTRIAN
8 EA
$2,216.00
$17,728.00
8
$17,728.00
PUSHBUTTONS
7
REMOVE PEDESTRIAN PUSHBUTTON STATION
8 EA
$70.00
$560.00
8
$560.00
8
3/C 14 AWG MULTI -CONDUCTOR CABLE
1020 LF
$6.00
$6,120.00
1020
$6,120.00
9
FURNISH/INSTALL GROUND BOX TYPE D,
1 EA
$5,118.00
$5,118.00
1
$5,118.00
W/APRON
10
REPLACE ATC SIGNAL CONTROLLER
I EA
$7,383.00
$7,383.00
1
$7,383.00
11
FURNISH/INSTALL 352I CONTROLLER
I EA
$34,881.00
$34,881.00
1
$34,881.00
CABINET ASSEMBL
12
REMOVE SIGNAL CABINET FOUNDATION
I EA
$1,210.00
$1,210.00
1
$1,210.00
13
INSTALL ALUM SIGN MAST ARM MOUNT
6 EA
$517.00
$3,102.00
6
$3,102.00
14
INSTALL ALUM SIGN GROUND MOUNT
I EA
$1,822.00
$1,822.00
1
$1,822.00
15
TRAFFIC CONTROL
1 MO
$8,000.00
$8,000.00
1
$8,000.00
Sub -Total of Previous Unit
---------------------------------
$101,500.00
$101,500.00
Tuesday, June 2, 2026 Page 3 of 5
City Project Numbers 105635
Contract Name BYs WHOLESALE CLUB
Contract Limits
Project Type DRAINAGE, PAVING, STREETLIGHTS & TRAFFIC
Project Funding
Contract Information Summary
Original Contract Amount
Change Orders
Change Order Number 2
Change Order Number 3
Total Contract Price
DOE Number 5636
Estimate Number I
Payment Number I
For Period Ending 5/26/2026
$548,438.40
$12,960.00
$78,061.50
$639,459.90
Total Cost of Work Completed $639,459.90
Less % Retained $0.00
Net Earned $639,459.90
Earned This Period $639,459.90
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
$639,459.90
Tuesday, June 2, 2026 Page 4 of 5
City Project Numbers 105635
Contract Name BJ's WHOLESALE CLUB
Contract Limits
Project Type DRAINAGE, PAVING, STREETLIGHTS & TRAFFIC
Project Funding
Project Manager NA
Inspectors G.DEYON / M.CAIN
Contractor MYCON GENERAL CONTRACTORS
208 E LOUISIANA STE 200
MCKINNEY , TX 75069
DOE Number 5636
Estimate Number 1
Payment Number I
For Period Ending 5/26/2026
City Secretary Contract Number
Contract Date
Contract Time 183 WD
Days Charged to Date 155 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 $639,459.90
Less % Retained
$0.00
Net Earned
$639,459.90
Earned This Period $639,459.90
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
$639,459.90
Tuesday, June 2, 2026 Page 5 of 5
DEVELOPER -AWARDED -PROJECT CHANGE ORDER
PROJECT NAME:
BJ's Wholesale Club
CHANGE
CONTRACT:
IPRC24-0144
ORDER No:
CFAN
CFA26.0050 CITY PARTICIPATION:1 NO
CITY PROJECT #
10635
CITY SECRETARY CONTRACT#
WA
2
FID At
30114.0200431-105635-EO7685
X #
X-28237
FILE #
K-3282
INSPECTOR: Phone No:
PROJECT MANAGER: Ahmed Musa Phone No: 817-392-2084
CONTRACT
UNIT
CONTRACT
DAYS
WATER
SEWER
DRAINAGE
PAVING
STREETLIGHTS
TRAFFIC
Developer
Ceet
Cit Coat
Dovelo er Coal
CI C00t
Do,oloper
Cosl
CityC0s1
Developer
Cast
CH Co.,
Oe wN,
Coot
C' Coll
Developer
Coat
C Cost
ORIGINAL CONTRACT
S1681165.0D
S000
$539,045,00
S0.0o
$179,686.50
$0,00
S102M6.9D
SO.OD
$16S,D25oD
$0.00
$101,9000D
SO,OD
0
EXTRAS TO DATE
$0.00
30oa
50.00
Soon
Mile
$0,00
SO.DO
$O.DD
$0.00
30.00
$0.00
loan
0
CREDITS TO DATE
$0.00
$0.00
30.00
$0.00
$0.00
$000
$0.00
$D,DO
$0.00
Wall
50,00
$oA0
0
CONTRACT TO DATE
$217.045,00
S000
S539.04.5.00
S0.00
$179,088.90
$000
$102.226.90
$0,00
$165,OZ8.00
$0.00
$101.500.00
$0.00
0
AMOUNT OF PROP. CHANGE ORDER
$0.00
S
$7.500.00
$oeo
$0.00
$D.oe
$0.00
Me.
S 12,960.00
Woe
$0.00
$000
D
REVISED CONTRACT AMOUNT
$217.045.00
$0.00
$546.545.00
11,11
1171,186.50
$0.00
$102,Y6.90
Mee
S177.985.00
SDA0
$1D1,500.00
Woo
0
TOTAL REVISED CONTRACT AMOUNT PER UNIT
$2170AS.D0
.,SASA0
$179.sa6.50
3102,22e.90
5177,905.oO
5101.5Do.00
REVISED COST SHARE
Dev. Coal: 51,324,988.40 iCity Cos%: $0.00
TOTAL REVISED CONTRACT
S1,324,986.40
You are dbaotod to make the following changoe in the ecml—t deeumenla:
TAL UNIT II' SEWER IMPROVEMENTS
PAY fTEM#
CITY SOU REM
QUANTITY
UNIT
ITEM DESCRIPTION
CPsaFWUna
UNIT PRICE
DeveloW Cost
CByCoal
TOTAL
2605,3016 2' CGNDT PVC SCH DO 81
6
160,00
LF
2' CONOT PVC SCH 60 I
S91.00
S -
S -
S 12,060.00
5
S
$
S
$
S
S
S
S
S
$
S
S
S
S
S
$
TOTAL UNIT V: STREET LIGHTS IMPROVEMENTS
A itedek (-) Indlcatee New Pay Item
REVIEWED
By Ahmed Musa at 9:23 am, Apr 17, 2026
Revised: 12-17-2018 Page 1
REASONS FOR CHANGE ORDER &k(ing-ok,uy sewor manhole r.ptecom,of.
Bore instead of T.-h for the 2' PVC condoir ina1a8ati,n.
By: ",�- By:_
Name: Drew Donosk, P.E. Name:
Till,: Civil Entree, Title:
/ By:
Nam.: William C Werner
A"YU/Y ltl G. Title: EVP - Bl's Wholesale Club
APPROVAL RECOMMENDED: APPROVED: APPROVED AS TO FORM AND LEGALITY:
CFW- Funding Department CFW-Assistant Ciy Manager CFW-Assistant Clly Attorney
By: By By:
Ime: Name: Name:
Title: Title: Title:
RECOMMENDED:
CFW. 'Ca he/ o9er, ATTEST • Contract Compliance knoedge
Manager the (Project Manager:
By signing I acknowledge that I am the person responsible
By: for the monitoring and adminislmli,n of this c,nlracl, include
Ahmed Musa ensuring all pedormance and reporling requirements.
Hama: _ Jannelle S. Goodall
Tiue:
Professional Engineer city se"elary Them are NO City Funds associated wth this Contract
❑ There are City Funds associated with this Contract
M&C Number.
M&C Data Approved:
REVIEWED
NyAhnned Musa at 9.23 am, Apr 17, 2026
Revised: 12-17-2018 Page 2
DEVELOPER -AWARDED -PROJECT CHANGE ORDER
PROJECT NAME:
BJ's Wholesale Club
CHANGE
CONTRACT:
IPRC24-0144
ORDER No:
CFAI
CFA25-0050 CITYPARTICIPATION[ Nu
CITY PROJECT R
10635
CITY SECRETARY CONTRACTIf
WA
FID f
30114-0200431-105635-EO7685
X a
X-28237
FILE a
K-3282
INSPECTOR Phone No
PROJECT MANAGER. Ahmed Musa Phone No 817-392-2084
CONTRACT
UNIT
CONTRACT
DAYS
WATER
SEWER
DRAINAGE
PAVING
STREETLIGHTS
TRAFFIC
Otwbpar
Cos,
C CUH
Dew ,Coal
C n Co
Dewbper
Con
C Cast
Dove per
Coal
C Con
vebpn
Cosl
C Cast -
Developer
Con
CO Con
ORIGINAL CONTRACT
SISSASSA0
ON
$539.046AO
ON
S179.688.50
OA0
$102.226.90
30,06
3166A2SAD
$0,00
3101.600h.
Som
0
EXTRAS TO DATE
41
1.11
$ON
$7.0.00
000AS
f0,00
Soho
SO.00
S.A.
son
30.00
ON
$0.00
OM
0
REORSTODATE
$0.60
SOAO
SO oo
IDA.
30A0
10.00
$0.00
ON
Soho
10.00
SCAB
II0.00
0
CONTRACT TO DATE
$217,043.00
SON
5644.646.00
90.00
$17SA86.50
so,"
S102.126.90
SOAO
$177.995.90
30.00
$101.500.0.
$0.00
0
AMOUNT OF PROP. CHANGE ORDER
"he
SOAO
$0.00
3o."
$SAO
Soho
S 781"ISO
10.0.
SO.00
$6.00
10.00
0
REVISED CONTRACTAMOUNT
S217445.00
son354i,545.69
$0.110
S179A31.So
S4.00
S180,288A0
$0.00
3177.966.00
0."$101.600.00
50.00
0
TOTAL REVISED CONTRACTAMOUNT PER UNIT
S217.046A0
3646.546A0
$179"00.50
3180201,fo
$177,SOX0
S101,500.00
REVISED COST SHARE
Dev. Coal: f7,403,049.00 City COSY. $0.00
TOTAL REVISED CONTRACT
S1,403,049.90
You We directed to make the following changes in the contract documents
Asterisk 11 Indicates Nm Pay item
14f.T SI:AAPli7.\rU1
REVIEWED
By Ahmed Musa at 9:28 am, Apr 17, 2026
Revised 12-17-2016 Page I
REASONS FOR CHANGE ORDER Estsing ..W y wear "MroM npfaCemxrf
Bon nstead of Trench for the 2' PVC c-" nsfaMpn_
RECOMMENDED:
APPROVED:
APPROVED:
By By
By. - I,,
Name Drew Donosta. P.E.
Name yWl!" C Weiner
Name; V.
Title. CW Engineer
Title EVP
APPROVAL RECOMMENDED:
APPROVED:
APPROVED AS TO FORM AND LEGALITY;
C7-FuMng Dope
By.
CFW- Assistant Coy Manager
By.
CFW- Assisfanf City Attorney
BY
Mains Ahmed Musa
Maurice.
Name
Ttltle, Professional Engineer
TgN:
TIIN.
RECOMMENDED:
CFW-'Contract Compliance Manager
ATTEST
• Contract Compliance Manager (Project Manager):
BY.
By signing 1 acknowledge Nat I am the person responsible
for the monitoring and administration of this contract. indude
ensuring all performance and reporting r"unemenle.
Name _
Jannet(. S. Goodall
City Secretary
0+ There are NO City Funds associated with this Contract
Title
❑ There are City Funds assonated wdh this Contract
Mac Number
Mac Date Approved
REVIEWED
By Ahmed Musa at 9:28 am, Apr 17, 2026
Revised 12-17 2019
Pogo'
FORTWORTH.
TRANSPORTATION AND PUBLIC WORKS
June 1, 2026
Mycon General Contractors
17311 Dallas Parkway, Suite 300
Dallas, TX 75248
RE: Acceptance Letter
Project Name: BJ's Wholesale Club Fort Worth
Project Type: Water, Paving, Storm Drain, Street Lighting
City Project No.: 105635
To Whom It May Concern:
On May 28, 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 May 29, 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 May 29, 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
Ahmed Musa 682-329-6025 100 Fort Worth Trail, Fort Worth, TX 76102.
Sincerely, 401
Ahmed Musa (Jun 17, 2026 13:49:16 CDT)
Ahmed Musa, Project Manager
Greg Robbins, Program Manager
Cc: Dana Carr, Inspector
Gary Deyon, Inspection Supervisor
Lorrie Pitts, Senior Inspector
Greg Robbins, Program Manager
Claymoore Engineering, INC., Consultant
MYCON General Contractors, Contractor
BJ's Wholesale Club, Inc., Developer
File
E-Mail: TPW_Acceptance@fortworthtexas.gov
Rev. 8/20/19
AFFIDAVIT
STATE OF Texas
COUNTY OF Dallas
Before me, the undersigned authority, a notary public in the state
and county aforesaid, on this day personally appeared Pierre Ifill,
Controller Of MYCON General Contractors, 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;
CPN 105635 BJ's Wholesale Club_yVaNr, Sewer, Dr ' age, Paving, Street
Lighting & Traffic.
IM
Ifill /Controller
Subscribed and sworn before me on this date 16th of June, 2026.
Z'sDenise Renee o
* My Commission Expires
Expire xpirsa
Notary ID125335859 k
���
Notary Public
Dallas, Texas
CONSENT OF
OWNER
❑
SURETY COMPANY
ARCHITECT
❑
TO FINAL PAYMENT
CONTRACTOR
❑
,4L4 DOCUMENT' G707
SURETY
❑
OTHER
❑ BOND # 460798G
PROJECT: BTs Wholesale Club #265, Intersection of Chisholm Trail & Altoa Mesa Boulevard, Fort Worth, TX 76104
(name. address)- Water, Sewer, Drainage, Paving, Street Lights and Traffic Improvements only
TO: (Owner)
City of Fort Worth
200 Texas St.
Fort Worth, TX 76102
CONTRACTOR:
MYCON General Contractors Inc
17311 Dallas Parkway, #300
Dallas. TX 75248
CONTRACT FOR: Construction
i
E
CONTRACT DATE: 4/19/2025
In accordance with the provisions of the Contract between the Owner and the Contractor as indicated above, the
(here insert name and address of Surety Company)
Ohio Farmers Insurance Company
P. O. Box 5001
Westfield Center, OH 44251-5001
on bond of
(here insert name and address of Contractor)
MYCON General Contractors Inc
17311 Dallas Parkway, #300
,SURETY COMPANY,
Dallas, TX 75248 ,CONTRACTOR,
k
hereby approves of the final payment to the Contractor, and agrees that final payment to the Contractorshall
not relieve the Surety company of any of its obligations to
(here insert name and address of Owner)
City of Fort Worth
200 Texas St.
Fort Worth, TX 76102 ,OWNER,
as set forth in the said Surety Company's bond
i
IN WITNESS WHEROF,
The Surety Company has hereunto set its hand this l Oth day of June , 2026
Ohio Farmers Insurance Company
Surety C y
Signature of Authorized Representative �a • > . i'., "
Attest: s ""-'d �o+.� rt • • ^ r , �� t
(seal) Donnie Doan Dawn Davis Attorney -In -Fact _` a • ,E3
Title Kj
ALA DOCUMENT G707 * CONSENT OF SURETY COMPANY TO FINAL PAYMENT -APRIL 1970 EDITION •AIA . • • . `. • ' ;+
1970 THE AMERICAN INSTITUTE OF ARCHITECTS, 1735 NEW YORK AVE. NW WASHINGTON, D.C_ 2006 ,;<`
General POWER NO. 422M72 04
Power Westfield insurance Co.
of Attorney Westfield National Insurance Co.
CERTIFIED COPY Ohio Farmers Insurance Co.
Westfield Center, Ohio
Know All Men by These Presents, That WESTFIELD INSURANCE COMPANY, WESTFIELD NATIONAL INSURANCE COMPANY and OHIO
FARMERS INSURANCE COMPANY, corporations, hereinafter referred to individually as a 'Company' and collectively as 'Companies,' duly
organized and existing under the laws of the State of Ohio, and having its principal office in Westfield Center, Medina County, Ohio, do by these
presents make, constitute and appoint
DONNIE D. DOAN, DAWN DAVIS, WALTER J. DELAROSA, CHRISTEN TYNER, ASHLIE DOOLEY, JESSICA ALlMAGUER,
13ARBARA SHAMARD, CASSIE PATTON, HELEN JONES, BRETT LOMAX, JOINTLY OR SEVERALLY
of DALLAS and State of TX Its true and lawful Attorney(s)-i n- Fact, with full power and authority hereby conferred in its name,
place and stead, to execute, acknowledge and deliver any and all bonds, recognizances, undertakings, consents of surety, or other instruments
or contracts of suretyship in any penal limit, and to bind any of the Companies thereby as fully and to the same extent as if such bonds were
signed by the President, sealed with the corporate seal of the applicable Company and duly attested by Its Secretary, hereby ratifying and
confirming all that the said Attorney(s)-in-Fact may do in the premises. Said appointment is made under and by authority of the following
resolution adopted by the Board of Directors of each of the WESTFIELD INSURANCE COMPANY, WESTFIELD NATIONAL INSURANCE COMPANY
and OHIO FARMERS INSURANCE COMPANY:
'Be It Resolved, that the President, any Senior Executive, any Secretary or any Fidelity & Surety Operations Executive or other Executive shall
be and is hereby vested with full power and authority to appoint any one or more suitable persons as Attorney(s)-in-Fact to represent and act for
and on behalf of the Company subject to the following provisions:
The Attorney -In -Fact may be given full power and authority for and In the name of and on behalf of the Company, to execute, acknowledge and
deliver, any and all bonds, recognizances, contracts, agreements of indemnity and other conditional or obligatory undertakings and any and all
notices and documents canceling or terminating the Company's liability thereunder, and any such instruments so executed by any such
Attorney -in -Fact shall be as binding upon the Company as if signed by the President and sealed and attested by the Corporate Secretary.'
'Be It Further Resolved, that the signature of any such designated person and the seal of the Company heretofore or hereafter affixed to any
power of attorney or any certificate relating thereto by facsimile, and any power of attorney or certificate bearing facsimile signatures or facsimile
seal shall be valid and binding upon the Company with respect to any bond or undertaking to which it is attached.' (Each adopted at a meeting
held on February 8, 2000).
In Witness Whereof, WESTFIELD INSURANCE COMPANY, WESTFIELD NATIONAL INSURANCE COMPANY and OHIO FARMERS INSURANCE
COMPANY have caused these presents to be signed by their Vice President, Surety and their corporate seals to be hereto affixed this 20th day
of AUGUST A.D., 2026 .
Corporate"• ..•`'•"""'••++, ..•,= WESTFIELD INSURANCE COMPANY
Seals s r"
Affixed . v� �p •.••••••..!Y• WESTFIELD NATIONAL INSURANCE COMPANY
�► ; o: . `°•., OHIO FARMERS INSURANCE COMPANY
~ "sUri SEAL
•_O;:_1646 ;;�•? /' r C`
State of Ohio �''•••,,,,*,,,++"` yyH+Lrylp.N�••,� By:
County of Medina ss.: Gary W. tumper, Vice President, Surety
On this 20th day of AUGUST A.D., 2025 , before me personalty came Gary W. Stumper to me known, who, being by me duly sworn,
did depose and say, that he resides in Medina, OH; that he is Vice President, Surety of WESTFIELD INSURANCE COMPANY, WESTFIELD
NATIONAL INSURANCE COMPANY and OHIO FARMERS INSURANCE COMPANY, the companies described in and which executed the above
instrument; that he knows the seals of said Companies; that the seals affixed to said instrument are such corporate seals; that they were so affixed
by order of the Boards of Directors of said Companies; and that he signed his name thereto by like order.
Notarial
Pay is
Affixed
s
Ir
State of Ohio °
County of Medina ss.: A
1r aF °.
David A. m ry Public
My Commission Does Not Expire (Sec. 147.03 Ohio Revised Code)
1, Kathleen Golovan, Chief Administrative Officer & Corporate Secretary of WESTFIELD INSURANCE COMPANY, WESTFIELD
NATIONAL INSURANCE COMPANY and OHIO FARMERS INSURANCE COMPANY, do hereby certify that the above and foregoing is a true and
correct copy of a Power of Attorney, executed by.sald Companies, which is still in full force and effect; and furthermore, the resolutions of the
Boards of Directors, set out in the Power of Attorney are In full force and effect.
In Witness Whereof. I have hereunto set my,hand'and ,affixed. the seals of said Companies at Westfield Center, Ohio, this 10th day of
June A.D., 2026
A
i � e
Kathleen Golovan, Chret' Administrative Officer &
!; Corporate Secretary
a
SPOAC2 (combined) (07-25)