HomeMy WebLinkAbout063487-FP3 - Construction-Related - Contract - Vernara LLCFORTWORTH.
TRANSPORTATION AND PUBLIC WORKS -FP3
NOTICE OF PROJECT COMPLETION
City Secretary No:
63487
Date Received: 07/07/2026
City Project No: 106091
Regarding Contract 63487 2025 Concrete Restoration Contract 4 for as required by the
Transportation & Public Works Department as approved by City Council on 6/10/25 through M&C 25-0530
the Director of the Transportation & Public Works Department, upon the recommendation of the Assistant Director
of the Transportation & Public Works Department, has accepted the project as complete.
Original Contract Amount:
Amount of Approved Change Orders:
Revised Contract Amount:
Total Cost of Work Completed:
Less Deductions:
Liquidated Damages:
Pavement Deficiencies:
Total Deduction Amount:
Total Cost of Work Completed:
Less Previous Payments:
Final Payment Due:
$2,149,650.00
Days 180
$387,650.00
No 1 Days Added by CO 45
$2,537,300.00
Total Days 225
$2,523,721.70
Days Charged215
$ 0.00
Days @
/Day =
$ 0.00
$2,523,721.70
($ 2,397,535.60)
OFFICIAL RECORD
$ 126,186.10
CITY SECRETARY
FT. WORTH, TX
?at;-iCia L. Pyo(sack
-'-trlcia L. Wadsack (Jul 2, 2026 12:09:59 CDT)
Recommended for Acceptance
Assistant Director, Transportation & Public Works - Capital Delivery
Lauren Prie. � l 2, 2026 13:48:22 CDT';
Accepted
Director, Transportation & Public Works
07/02/2026
Date
07/02/2026
Date
CU
U_
O
O
a a
Q
c
E
a
ci
N
p
C
N
O
p
3
O
s
..
u m
w '�
w
bA
a E
a
m o
m
m
N Z
O N
y
.. $
E^
d>
O N
DV c a
E
aowin a`O
�Nna
s Q
U �
ty0
a
C N
U N
O1 O
t
A
k
Ln
0
m
E
In
M
w
'100
J
O 00 O
O O O O N
O N N O Nn O
O O O n
O O O
O r l0 m
Do --dl N
N N
tD l0 M h
r V1 N to
(7 N n
M n l0 m
t oo M N
N m N c-I
N L} N N
N N VT VT
"o u
N U
W p
_ �
U
�
c
y o J
f0 ¢ p
w a
�v a
c
w o o v ,
w w v c c
' 3 'o a 'c
Q > a.
v 2 "o
v
s> E E
m
O O O N O O
E c E a U V p N Q
"OO t` w w
¢L¢ yar,' o E¢a
a >•.
a
v
@ a C
N
muILI�.LL b
T IO �„
Q Q U U U
O
E onDo� v° o=o�E
mm'�mm0
To
E u u E O w '� p �'
p p F� p p U
v ao c o o a o c v E
ro � u -o ai w
N ^ = C
O Z U t° a u ¢¢¢ m` U
c
V N N M V V1 lD n DO Ol
E
O
'o
c
LL
0
p
0 0 0
o 0 0
0
0
0
0
0
o
0 o O o
M
0
o
0 0
0 0
0
0
u _
O
oc
O
O
O
O
O
N
00 N
.�i W ti IR
O
Lq N
O
m
N o
m
Im
N
f0 It
m
�
Ll
N
0 o m
o
o
ry
w ry m
n
o 0
0
co
a
0
0
0 w n n
p ID
•+ N
C �
O
�
L
O
p
o 0 0
0
O
0
o
0
O O O O
0 0 0 0
O
0
O O
0 0
O
0
Q-
`w
c
0
v
lo
0 0 0
O O O
0
O
0
O
0
O
0 0 0 0
N N u'1 C]
0
O
0 0
O O
0
O
W
LL
O O
O�1 1� i1m1 N
ti e0 ti
O
o
V
I
=
O. o
+^ o VI
VT
VT
Qj M N
N
h
n
E
n
u c o
m
a
�•
o 0 0
0
0
0
0 0 0 0
0
0 0
0
upi O
yr - -
-
-
-
- - - yr
-
- -
-
ate+
� a
0 0 0
0
0
0
0 0 0 0
o]
0
O
0 0
O O
0
O
W
2am 10
N O u1
W
T M N
N
z
Q
>
v Y
o 0 0
o 0 0
0
0
0
0
0 0 0 0 0 0 0
0 �o 0 0 0
N O T
0
0
O
0 0
0 0
O O
0
0
O
..•
D
•�
v
O
O
o
m m o]
c
O
o
O
O
LL iJ
CCr
O.
O
N
.p-' .-i nt
(••)
t�➢
O O O
O
O
O
O O o O
O O O O
O
O
O O
O O
O
O
O
N — —
—
—
—
— — — —
—
— N
—
qJ
0
N
d
�a
o
{
a-
N
o 0 0
0
0
0
0 0 0 0
0
0 0
0
U
v
Y
0 0 0
o 0 0
0
o
0
O
0
o
0 0 0 0
0 0 o O
0
o
0 0
0 0
0
0
Y
0
0
0 0 0 0
0
0 0
0
4-
U
m v '�
VI
aE-� r v a
i
U
w c
U
-
o 0 o
O
O
o
0 0 0 0
0
0 0
0
\
5
0
a
0 0 0
C 0
0
0
C
0
0
0 0 0 0
0 0
c c
0
c
0 0
0 0
0
0
'p ih
m
>
0 0
M
0
o
e
V
o 0 0 0c
tD ✓�1 d' I�
o
m
Lri m
N O
o
W
C
O O O
O
O
O
O O O O
O O O
O
O
O O
O O
O
O
a C
0
0
ry
0
c
ry
0
c
m
0 0 0 0
o w n oc
ni ti
0
0 0
o N
m
0
o
.,
co m
cr
cr
O
w
V1
Vf
N
N u N
Z
N
>
V
V
C
O
Q
U t
Oz
n w
c
v
>
v
o v
c
E
v
a
�a 'o
o
o
u
w
m
o
u
a -o °1 Q
v w F Q
_
a
v
+
o
- O
E
o
O
O
O O L m
O
N
w cD
v c=
E
u
E
u N
Q
.O
E
o 0 0 o
0
0 3
o E
u
n Em om
m
z
.m.>rv'>°rnl7mQ ry
v a
'O
�
o�ouo
cc
` M� oN
000
M X Ol O1 ~ W M
amwmdm
tN�'1 N ry
rrm
M
v
m
c
A
E
'O
N
'E 'E N 'E m E 7 E I 'E I 'E n 'E I E o
'C p 'C o 'C o 'C o 'C p 'C p 'L p 'C o 'C o 'C
0 0 0 0 0 0 0 0 0 0
'E E ry •+ m 'E a
'C .i �� '� .-1 'C
0 0 0 0
d
O
N
N
to
a
p
0
o
0
0
0
0
0
0
0 0
0 0
0 0 0 0
0 0 0 0
0
0
0 0 0 0
0 0 0 0
0
0
L
y N '2
0
O
v1
0
O
O
0
O
N
0
O
00
0
ut
N
0 0 0 0
O O O O
O Vt O lD
0
O
O
0 0 0 0
O O O O
O O V V1
0
O
O
[p
O
o
o
o
O
0
o
0
0
O
00
0
0 O
0
0
0 O o 0
0 0 0 0
0 0 o a
o
0
o
O O o h
0 0 0
0 0
o
O
o
=
00
00
N
L
m p
O
O
O
O
O
O
O
O
O O
O O
O O O O
O O O O
O
O
O O O O
O O O O
O
O
C Gl
v
cc
N a +
0
0
0
0
0 0
0
0 0 0 0
00 0
0
0 0 0 0
0 0
0
m d d+
°
O a m
u � o
^
A a LL
0
0
0
0
0 0
0 0 0 0
0
0 0 0 0
0
•V N O
—
—
—
N
— Vi
N N — N
N
N — — V}
lA
� a
0
0
0
0
0 0
0 0 0 0
0
0 0 0 0
0
T
7 d
o
0
0
o
O o
O
0 0 0 0
o VO
0
o O o O
0 ON
o
a
>
a „>,
0
0
0
0
0
0
0
0
0 0
0 0
0 0 0 0
0 0 0 0
0
0
0 0 0 0
0 0 0 0
0
0
c �
a C
U
o
0
0
0
0
0
0
0
0 0
0 0
0 0 0 0
0 0 0 0
0
0
0 0 0 0
0 0 0 0
0
0
IN
—
—
—
— —
— — — —
—
— — — VT
VT
—
a
Q0
0
0
0
0 0
0 0 0 0
0
0 0 0 0
0
U
a�Y
0
0
0
0
0 0
0 0 0 0
0
0 0 0 0
0
a-•+
E m m w`
VI
= Va
W C
O
O
O
O
O O
O O O O
O
O O O O
O
W
3
O
O
O
O
O
O
O
O
O
O
O
O
O O
C O
O ut
O O O O
O O O
O O O
N C
O
O
O
O O O O
O O
O O O O
C�
O
O
O
O2
Vl
O
N
a0
N
VO
�
V O
O
�O
O a O
cY �
O
n
3
O
O
an
O
O
O
O
o
O
vi ul
O O
O O
try
an v}
o O O O
O O O O
O
O
of vi
O O o o
O O O O
va
o
o
N
u
a
O
in
O
C
N
N
ti
00
N
O O
v� N
O 00 O O
ry
O
O O oo 00
o
LL �0
O
O
N
O O
O
O O O
O
J
d
O
w
W
in
N
w w
w W w
w
W W w w
C
O
•-
Q
u
C
va Z
`�°
Q
v
v
o a
m
o3
v a 'vc-i
v L°
E
E
`-�
v v
v '-�
v
�¢ LL� ou ° ov a`,
u v on
ot°�
v u
d
N� N
E
� ,�-� ie Y
v
E
N
v
E V1 'E N E r Y W 'E Ot 'E O ♦+ E N 'E M 'E 'E tp 'E i� �+ W ++ O1
.0 .0 .0 � .� .0 � .0 .0 N .0 N .0 N .0 N .0 .0 N .0 ry .0 N .0
O O O O O O O O O O O O O O O
♦+ O
.0 m
O
a p-
m Z
V"
O
M
p
o
0
0
0
0
0
0
0 0
u 2
0
0
0
0
0
0
0
c
o m
c
Y
N
LL "
m
N
fr1
m
o
o
Iq
o
0
0
0
0 -p
v
m
r
m o
0
0
0
0
0
0
0
o
lo
0oo
_
•r
e
m
'10 4
v
cc
N
N
N
N
N
N
N
N
o
a +7
o
0
o
o
0
o
o
0
0
0
y
m
u � o
0
0
0
0
0
0
0
0 0
C Ol C
•� O O
N
N
N
N
N
N
N
N
� a
T
o
o
o
O
o
o
o
O
0
O
o
O
o
O
o 0
o n
7 d
OO1
O
N
1
'•j
Vf
—' a>
o
o
0
o
o
o
o
o
m
m
o
00
0
0
0
a
v
o
0
0
0
0
0
0
0 0
O
« a
o
� a
i
Qo
o
0
0
0
o
o
0
a-
�
aYa
W C
r i
O
O
O
O
O
O
O
O O
O
O
n
N
N
m
N
N
VT
N
-
a
C
o
O
t0
N
O
O
l0
N
O
O
N
O
O
O
v
N
o
O
m
N
O
O
N
o
O
O
m
N
a •�
m �0
m
.,
J
d
O
w
w
w
C
O
u •-
a c
v � z
c
�
_
` � � �
`
c f
o Y
" " c M
n v v �+
o E o 0 E o a
o
uc�
] u
v
U c o
n � ,-�
p b0 O Q oD O O
E
O
O O C O c 0
ai 3 0
o o m
2
in
m F m H E
E
Q1
'E N E N •+ M ♦+ 7 E VI Y H n ♦+ 00
� O � o � o� o� aE oE o E o
'm z
a
0
e
cu
to
n
FORT WORTH,;,
Routing and Transmittal Slip
Transportation & Public Works
Department
DOCUMENT TITLE: 2025 CONCRETE RESTORATION CONTRACT 4 - CO 1
M&C: 26-0170
CPN: 106091 CSO: 63487 DOC#:1
Date:
To:
Name
Department
Initials
Date Out
1.
Lizbeth Medina
Bus-Sppt
LM
03/12/26
2.
Vernara, LLC
Vendor
A8
03/12/26
3.
Brandon Gibson
TPW - Inspector
13
,--
03/12/26
4.
Randall Horton
TPW - Sr.Inspector
7alr
03/12/26
5.
1 Iretomiwa Otuyelu
TPW
1 0
03/12/26
6.
Zelalem Arega
TPW
Ze,xmArega
03/19/26
7.
Mary Hanna
TPW
03/20/26
8.
Patricia Wadsack
TPW AD
03/25/26
9.
Lauren Prieur
TPW Director
La�UP Pd-
03/25/26
10.
Doug Black
Legal
03/27/26
11.
Jesica McEachern
CMO
0M
03/27/26
12.
Jannette Goodall
CSO
a ��od—„
03/30/26
13.
TPW Contracts
TPW
CC: Program Manager, Sr. CPO, TPW BSPAP Recon Team, TPW Records Room, TPW Contracts
ALSO List: - Bus Sppt: Lizbeth Medina; Prg Mgr.: Zelalem Arega; Sr CPO — Mary Hanna
DOCUMENTS FOR CITY MANAGER'S SIGNATURE: All documents received from any and all
City Departments requesting City Manager's signature for approval MUST BE ROUTED TO THE
APPROPRIATE ACM for approval first. Once the ACM has signed the routing slip, Jay will review and
take the next steps.
NEEDS TO BE NOTARIZED: [-]YES ®No
RUSH: ❑YES ®No
ROUTING TO CSO
SAME DAY: ❑YES ❑No
®YES ❑No
Action Required:
❑ As Requested
❑ For Your Information
® Signature/Routing and or Recording
❑ Comment
❑ File
NEXT DAY: ❑YES ❑No
❑ Attach Signature, Initial and Notary Tabs
Return To: Please notify TPWContracts(a fortworthtexas.2ov for pickup when complete. Call ext. 7233 or ext.
8363 with questions. Thank you!
FORT WORTH.
City Secretary's Office
Contract Routing & Transmittal Slip
Contractor's Name: Vernara, LLC
Subject of the Agreement: Change Order No. 1 to CSC No. 63487, a Contract for the 2025
Concrete Restoration Contract 4 Project at Various Locations
M&C Approved by the Council? * Yes 8 No ❑
If so, the M&C must be attached to the contract.
Is this an Amendment to an Existing contract? Yes ❑ No 8
If so, provide the original contract number and the amendment number.
Is the Contract "Permanent"? *Yes 8 No ❑
If unsure, see back page for permanent contract listing.
Is this entire contract Confidential? *Yes ❑ No 8 If only specific information is
Confidential, please list what information is Confidential and the page it is located.
1295 Form - page 8
Effective Date:
Expiration Date:
If different from the approval date. If applicable.
Is a 1295 Form required? * Yes 8 No ❑
*If so, please ensure it is attached to the approving M&C or attached to the contract.
Project Number: If applicable. 106091
*Did you include a Text field on the contract to add the City Secretary Contract (CSC)
number? Yes 8 No ❑
Contracts need to be routed for CSO processing in the following 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. 63487-COI
FORT WORTH.. City of Fort Worth
Change Order Request
Project Name 2025 Concrete Restoration Contract 4 City Sec # 63487
Client Project #(s) 106091
Project
Concrete pavement panel replacement at various locations
Contractor Vernara, LLC Change Order # 1 Date 3/10/2026
City Project Mgr. Iretomiwa Otuyelu City Inspector Brandon Gibson
Dept.
Original Contract Amount
Extras to Date
Credits to Date
Pending Change Orders (in M&C Process)
Contract Cost to Date
TPW
Totals
Contract Time
(CD)
$2,149,650.00
$2,149,650.00
180
$2,149,650.00
$2,149,650.00
180
Amount of Proposed Change Order
$387,650.00
$387,650.00
45
Revised Contract Amount $2,537,300.00
Original Funds Available for Change Orders $214,965.00
Remaining Funds Available for this CO $214,965.00
Additional Funding (if necessary) $172,685.00
CHANGE ORDERS to DATE (INCLUDING THIS ONE) AS % OF ORIGINAL CONTRACT
MAXALLOWABLE CONTRACT AMOUNT (ORIGINAL CONTRACT COST+ 25%)
$2,537,300.00
225
$214,965.00
$214,965.00
$172,685.00
18.03%
$2,687,062.50
JUSTIFICATION (REASONS) FOR CHANGE ORDER
IN ACCORDANCE WITH THIS CHANGE ORDER REQUEST, THE CONTRACTOR SHALL: Furnish all labor and materials as outlined in proposed Change Order #1. This
change order increases the quantities of existing bid items required to complete the concrete panel removal and replacement on Gold Spike Drive and Railhead Road. During
construction, additional concrete panels deteriorated and failed due to the ongoing construction activities and sustained heavy semi -truck traffic serving the surrounding industrial
properties. As a result, the quantity of concrete pavement requiring removal and replacement has increased by approximately 5,600 square yards above the original estimated
amount.
Time: Staff supports the contractor's request for an additional forty-five (45) calendar days to complete the expanded scope of work.
Cost: Part of this Change Order will be funded using the remaining construction allowance.
It is understood and agreed that the acceptance of this Change Order by the contractor constitutes an accord and satisfaction and represents payment in full
(both time and money) for all costs arising out of, or incidental to, the above Change Order. The Project/Program Manager signing below acknowledges that
he/she is the person responsible for the monitoring and administration of this contract, including ensuring all performance and reporting requirements.
Contractor's Company Name
Contractor (Name)
Contract Signature
Date
Vernara, LLC
Ashkan Beheshti
al,ns�kn
�n�=,,, ,1_ ,1 _ � �r,
03/12/26
Inspector/Inspection Supervisor
Date
Project and Contract Compliance Manager
Date
Brandon Gibson
03/12/26
_„_111„
03/12/26
Program Manager
Date
Senior Capital Project Officer
Date
7.41VIA Ut _..
03/19/26
�1r�.v—•.
03/20/26
Assistant Director (Dept)
Date
Director, Contracting Department (Dept)
Date
03/25/26
de__ 7,
03/25/26
Assistant City Attorney
Date
Assistant City Manager
Date
03/27/26
03/27/26
Council Action (if required)
M&C Number 1 26-0170 M&C Date Approved 3/10I2026
ATTEST:
Jannette Goodall, City Secretary
FORT WORTH City of Fort Worth
Change Order Additions
Project Name 2025 Concrete Restoration Contract 4 City Sec # 63487
Client Project # 106091
Contractor Vernara, LLC PM IretomMa Otuyelu Inspector Brandon Gibson
Change Order Submittal # Date 3/10/2026
ADDITIONS
ITEM
DESCRIPTION
DEPT
Qty
Unit
Unit Cost
Total
0241.1000 Remove Conc Hvmt
7
3213.0 fO4 9" Concrete Pavement
TPW
5,600.00000000
SY
$95.05
5
8
3123.0102 Unclassified Excavation by Survey
TPW
1.000.00000000
CY
$30.05
35
3471.0001 Traffic Control
TPW
1.00000000
MO
3.500.00
5
TPW
$699,900.00
Sub Total Additions
$699,900.00
Change Order Additions Page 2 of 3
FORTWORTH City of Fort Worth
Change Order Deletions
Project Name 2025 Concrete Restoration Contract 4 City Sec # 63487
Client Project # 106091
Contractor Vernara, LLC PM Iretomiwa Otuyelu Inspector Brandon Gibson
Change Order Submittal # O1 Date 3110/2026
DELETIONS
ITEM
DESCRIPTION
DEPT
Qty
Unit
Unit Cost
Total
Specified Remobilization
4
024 .0401 Remove Concrete Drive
TPW
1,500.00000000
SF
$2.05
5
3213,04016" Concrete Driveway
TPW
1,500.00000000
SF
8.00
9
9999.0003 Flexible Base, Type A, GR-s
TPW
500.00000000
CY
50.00
5,
10
9999.0004 Geogrid Tensar (TRIAX 140-475) or Approved Equal
TPW
3,900.00000000
SY
2.00
12
3292,0100 Block Sod Replacement
TPW
2,000.00000000
SY
$15.00
13
3291.0100 Topsoil
TPW
150.00000000
CY
43.00
15
0241.0300 Remove ADA Ramp
TPW
4.00000000
EA
500.00
16
3213.0506 Barrier Free Ramp, Type P-1
TPW
4.00000000
EA
2,000.00
17
0241.0100 Remove Sidewalk
TPW
300.00000000
SF
2.00
18
3213,03014" Conc Sidewalk
TPW
300,00000000
SF
8.00
34
3305.0105 Inlet Adjustment
TPW
3.00000000
EA
$4,000.00
36
3346.0007 4" Pipe Underdrain, Type 7
TPW
100.00000000
LF
50.00
37
9999.0001 Irrigation Adjustment & Landscape Repair Allowance (Irrigation)
TPW
0.80000000
LS
35, 000.00
38
9999.0002 Construction Allowance
TPW
0.80000000
LS
150,000.00
TPW
$312,250.00
Sub Total Deletions
312,250.00
Change Order Deletions Page 3 of 3
City of Fort Worth,
Mayor and
Texas
Council Communication
DATE: 03/10/26 M&C FILE NUMBER: M&C 26-0170
LOG NAME: 202025 CONCRETE RESTORATION CONTRACT 4 — C01
SUBJECT
(CD 2) Authorize Execution of Change Order No. 1, in the Amount of $387,650.00, and the Addition of 45 Calendar Days to the Construction
Contract with Vernara LLC, for the 2025 Concrete Restoration Contract 4 Project for a Revised Contract Amount of $2,537,300.00
RECOMMENDATION:
It is recommended that the City Council authorize execution of Change Order No. 1, in the amount of $387,650.00, and the addition of 45 calendar
days to the City Secretary Contract No. 63487 with Vernara LLC, for the construction of the 2025 Concrete Restoration Contract 4 project (City
Project No. 106091) for a revised contract amount of $2,537,300.00.
DISCUSSION:
On June 10, 2025, Mayor & Council Communication (M&C) 25-0530, awarded the City Secretary Contract No. 63487 with Vernara LLC, in the
amount of $2,149,650.00 for the construction of the 2025 Concrete Restoration Contract 4 project (City Project No. 106091) at Gold Spike Drive
from Meacham Boulevard to Railhead Road, Railhead Road from Northeast Loop 820 Service Road Eastbound to Blue Mound Road, and Robert
W. Downing Drive from Western Center Boulevard to Cedar Tree Drive.
During construction, additional concrete panels on Gold Spike Drive and Railhead Road deteriorated and failed due to the ongoing construction
activities and sustained heavy semi -truck traffic serving the surrounding industrial properties. As a result, the quantity of concrete pavement
requiring removal and replacement has increased by approximately 5,600 square yards above the original estimated amount. Change Order No. 1
is necessary to add additional concrete panel replacement quantities to restore the pavement to a safe and serviceable condition and to ensure
the roadway can adequately support existing heavy vehicle traffic.
Staff has reviewed and verified the quantities for the additional work under this Change Order No. 1. In addition, to complete this work, staff
recommends extending the contract time by 45 calendar days.
The following table summarizes previous contract action and change orders:
Construction Contract
Date
Amount
Original Contract Amount (M&C 25-06/10/2025
0530)
$2,149,650.00
Change Order No. 1
This M&C
$387,650.00
Revised Contract Amount
$2,537,300.00
This change order will have no impact on the Transportation and Public Works Department's annual operating budget. Funding is budgeted in the
General Capital Projects Fund for the Transportation and Public Works Department for the purpose of funding the 2025 Concrete Restoration 4
project, as appropriated.
This project is located in COUNCIL DISTRICT 2.
FISCAL INFORMATION / CERTIFICATION:
The Director of Finance certifies that funds are available in the current capital budget, as previously appropriated, in the General Capital
Projects Fund for the 2025 Concrete Restoration 4 project to support the approval of the above recommendation and the execution of the change
order. Prior to any expenditure being incurred, the Transportation and Public Works Department has the responsibility to validate the availability of
funds.
Submitted for City Manager's Office by- Jesica McEachern 5804
Originating Business Unit Head: Lauren Prieur 6035
Additional Information Contact: Monty Hall 8662
CERTIFICATE OF INTERESTED PARTIES
FORM 1295
1 of 1
Complete Nos. 1- 4 and 6 if there are interested parties.
Complete Nos. 1, 2, 3, 5, and 6 if there are no interested parties.
OFFICE USE ONLY
CERTIFICATION OF FILING
Certificate Number:
2026-1411335
Date Filed:
01/21/2026
Date Acknowledged:
1
Name of business entity filing form, and the city, state and country of the business entity's place
of business.
VERNARA LLC
DALLAS, TX United States
2
Name of governmental entity or state agency that is a party to the contract for which the form is
being filed.
CITY OF FORT WORTH
g
Provide the identification number used by the governmental entity or state agency to track or identify the contract, and provide a
description of the services, goods, or other property to be provided under the contract.
106091
2025 Concrete Restoration Contract 4 - Change Order No. 1
4
Name of Interested Party
City, State, Country (place of business)
Nature of interest
(check applicable)
Controlling
Intermediary
5
Check only if there is NO Interested Party. ❑
X
6
UNSWORN DECLARATION
My name is Ashkan Beheshti and my date of birth is 11-08-1990
My address is 17250 Dallas Pkwy Dallas Tx 75248 USA
(city) (state) (zip code) (country)
I declare under penalty of perjury that the foregoing is true and correct.
Executed in Dallas County, State of TX on the 21 day of 01 2026
(month) (year)
Signature of authorized agent of contracting business entity
(Declarant)
Forms provided by Texas Ethics Commission www.ethics.state.tx.us Version V4.1.0.22701b2a
106091-CNCO-2025 CONCRETE
RESTORATION CONTRACT 4 - CO 1
Final Audit Report 2026-03-30
Created: 2026-03-12
By: Andrea Munoz (Andrea.Munoz@fortworthtexas.gov)
Status: Signed
Transaction ID: CBJCHBCAABAAcOBXmjfCGWDiOQLCH4UQN-Sz55g1ONvg
"106091-CNCO-2025 CONCRETE RESTORATION CONTRAC
T 4 — CO 1" History
A Document created by Andrea Munoz (Andrea. M u noz@fortworthtexas.gov)
2026-03-12 - 3:29:25 PM GMT- IP address: 204.10.90.100
- h Document emailed to Lizbeth Medina (Lizbeth.Medina@fortworthtexas.gov) for filling
2026-03-12 - 6:15:29 PM GMT
- Document emailed to ashkan@vernara.com for signature
2026-03-12 - 6:15:30 PM GMT
-". Document emailed to brandon.gibson@fortworthtexas.gov for signature
2026-03-12 - 6:15:30 PM GMT
Email viewed by Lizbeth Medina (Lizbeth.Medina@fortworthtexas.gov)
2026-03-12 - 6:16:09 PM GMT- IP address: 104.47.65.254
F Form filled by Lizbeth Medina (Lizbeth.Medina@fortworthtexas.gov)
Form filling Date: 2026-03-12 - 6:16:56 PM GMT - Time Source: server- IP address: 204.10.91.100
Email viewed by ashkan@vernara.com
2026-03-12 - 6:21:11 PM GMT- IP address: 172.56.20.32
Signer ashkan@vernara.com entered name at signing as Ashkan Beheshti
2026-03-12 - 7:33:50 PM GMT- IP address: 172.56.20.232
=- Document e-signed by Ashkan Beheshti (ashkan@vernara.com)
Signature Date: 2026-03-12 - 7:33:52 PM GMT - Time Source: server- IP address: 172.56.20.232
Email viewed by brandon.gibson@fortworthtexas.gov
2026-03-12 - 8:25:39 PM GMT- IP address: 104.47.64.254
FORTWORTH.. Paweredby
Adobe
Acrobat Sign
C' Signer brandon.gibson@fortworthtexas.gov entered name at signing as Brandon Gibson
2026-03-12 - 8:26:26 PM GMT- IP address: 107.115.5.12
c Document e-signed by Brandon Gibson (brandon.gibson@fortworthtexas.gov)
Signature Date: 2026-03-12 - 8:26:28 PM GMT - Time Source: server- IP address: 107.115.5.12
Document emailed to Randall Horton (Randall.K.Horton@fortworthtexas.gov) for signature
2026-03-12 - 8:26:32 PM GMT
Document emailed to Iretomiwa Otuyelu (Iretomiwa.Otuyelu@fortworthtexas.gov) for signature
2026-03-12 - 8:26:32 PM GMT
`i Email viewed by Iretomiwa Otuyelu (Iretomiwa.Otuyelu@fortworthtexas.gov)
2026-03-12 - 8:26:41 PM GMT- IP address: 51.54.38.120
Email viewed by Randall Horton (Randall.K.Horton@fortworthtexas.gov)
2026-03-12 - 8:27:56 PM GMT- IP address: 104.47.65.254
c,c, Document e-signed by Iretomiwa Otuyelu (Iretomiwa.Otuyelu@fortworthtexas.gov)
Signature Date: 2026-03-12 - 8:28:13 PM GMT - Time Source: server- IP address: 166.205.58.55
C Document e-signed by Randall Horton (Randall.K.Horton@fortworthtexas.gov)
Signature Date: 2026-03-12 - 8:34:26 PM GMT - Time Source: server- IP address: 204.10.90.100
- Document emailed to Zelalem Arega (Zelalem.Arega@fortworthtexas.gov) for signature
2026-03-12 - 8:34:29 PM GMT
=4 Document e-signed by Zelalem Arega (Zelalem.Arega@fortworthtexas.gov)
Signature Date: 2026-03-19 - 1:54:34 PM GMT - Time Source: server- IP address: 204.10.90.100
?- r Document emailed to Mary Hanna (Mary.Hanna@fortworthtexas.gov) for signature
2026-03-19 - 1:54:37 PM GMT
Email viewed by Mary Hanna (Mary.Han na@fortworthtexas.gov)
2026-03-19 - 2:32:16 PM GMT- IP address: 166.205.54.49
<<, Document e-signed by Mary Hanna (Mary.Hanna@fortworthtexas.gov)
Signature Date: 2026-03-20 - 3:32:57 PM GMT - Time Source: server- IP address: 204.10.90.100
_E Document signing automatically delegated to Lissette Acevedo(lissette.acevedo@fortworthtexas.gov) by
Patricia Wadsack (patricia.wadsack@fortworthtexas.gov)
2026-03-20 - 3:32:59 PM GMT
Document emailed to Patricia Wadsack (patricia.wadsack@fortworthtexas.gov) for signature
2026-03-20 - 3:33:00 PM GMT
FORTWORTH.. Paweredby
Adobe
Acrobat Sign
Document emailed to Lissette Acevedo (lissette.acevedo@fortworthtexas.gov) for signature
2026-03-20 - 3:33:00 PM GMT
c Document e-signed by Lissette Acevedo (lissette.acevedo@fortworthtexas.gov)
Signature Date: 2026-03-25 - 10:08:24 PM GMT - Time Source: server- IP address: 204.10.90.100
Document emailed to Lauren Prieur (Lauren. Prieur@fortworthtexas.gov) for signature
2026-03-25 - 10:08:25 PM GMT
Email viewed by Lauren Prieur (Lauren.Prieur@fortworthtexas.gov)
2026-03-25 - 10:08:30 PM GMT- IP address: 51.54.38.123
=4 Document e-signed by Lauren Prieur (Lauren.Prieur@fortworthtexas.gov)
Signature Date: 2026-03-25 - 10:11:17 PM GMT - Time Source: server- IP address: 208.184.124.181
Document emailed to Lorita Lyles (Lorita.Lyles@fortworthtexas.gov) for approval
2026-03-25 - 10:11:20 PM GMT
`+ Email viewed by Lorita Lyles (Lorita.Lyles@fortworthtexas.gov)
2026-03-26 - 1:08:44 PM GMT- IP address: 104.47.65.254
c,�L, Document approved by Lorita Lyles (Lorita.Lyles@fortworthtexas.gov)
Approval Date: 2026-03-26 - 1:16:54 PM GMT - Time Source: server- IP address: 208.184.124.181
Document emailed to Douglas Black (Douglas.Black@fortworthtexas.gov) for signature
2026-03-26 - 1:17:05 PM GMT
=4 Document e-signed by Douglas Black (Douglas. Black@fortworthtexas.gov)
Signature Date: 2026-03-27 - 10:50:48 PM GMT - Time Source: server- IP address: 208.184.124.181
?- r Document emailed to Jesica McEachern Qesica.mceachern@fortworthtexas.gov) for signature
2026-03-27 - 10:50:50 PM GMT
Document e-signed by Jesica McEachernaesica.mceachern@fortworthtexas.gov)
Signature Date: 2026-03-27 - 11:09:28 PM GMT - Time Source: server- IP address: 208.184.124.181
-G Document approval automatically delegated to Cristian Chavez (cristian.chavez@fortworthtexas.gov) by
Katherine Cenicola (katherine.cenicola@fortworthtexas.gov)
2026-03-27 - 11:09:31 PM GMT
Document emailed to Cristian Chavez (cristian.chavez@fortworthtexas.gov) for approval
2026-03-27 - 11:09:32 PM GMT
Document emailed to Katherine Cenicola(katherine.cenicola@fortworthtexas.gov) for approval
2026-03-27 - 11:09:32 PM GMT
FORTWORTH.. Paweredby
Adobe
Acrobat Sign
Email viewed by Cristian Chavez (cristian.chavez@fortworthtexas.gov)
2026-03-27 - 11:09:37 PM GMT- IP address: 51.54.38.112
c Document approved by Cristian Chavez (cristian.chavez@fortworthtexas.gov)
Approval Date: 2026-03-30 - 1:51:55 PM GMT - Time Source: server- IP address: 208.184.124.181
Document emailed to Jannette Goodall Qannette.goodall@fortworthtexas.gov) for signature
2026-03-30 - 1:51:56 PM GMT
15_'11 Email viewed by Jannette Goodall Oannette.goodall@fortworthtexas.gov)
2026-03-30 - 1:52:48 PM GMT- IP address: 104.47.65.254
4 Document e-signed by Jannette Goodall Qannette.goodall@fortworthtexas.gov)
Signature Date: 2026-03-30 - 1:56:44 PM GMT - Time Source: server- IP address: 208.184.124.181
Form filling automatically delegated to Elisa Winterrowd (Elisa.Winterrowd@fortworthtexas.gov) by Allison
Tidwell (allison.tidwell@fortworthtexas.gov)
2026-03-30 - 1:56:46 PM GMT
Document emailed to Allison Tidwell (allison.tidwell@fortworthtexas.gov) for filling
2026-03-30 - 1:56:47 PM GMT
s Document emailed to Elisa Winterrowd (Elisa.Winterrowd@fortworthtexas.gov) for filling
2026-03-30 - 1:56:47 PM GMT
Form filled by Allison Tidwell (allison.tidwell@fortworthtexas.gov)
Form filling Date: 2026-03-30 - 4:21:44 PM GMT - Time Source: server- IP address: 208.184.124.181
Agreement completed.
2026-03-30 - 4:21:44 PM GMT
FORTWORTH.. Paweredby
Adobe
Acrobat Sign
Affidavit of Compliance with
City of Fort Worth
Prevailing Wages
1, Sl-iLjat� LC-*-6SH � l
(Name of person signing affidavit) ('title)
do hereby certify that the wages paid to all employees of k' rJzN Px- u—C
(Company Name)
for all hours worked on the
fir. Co � C lZ � STU 01 �i
(Project name and location)
#�t r n
project, during the period from ti``� 2--1 to j Tpc+ ,?ZM� 2pZ ,
(Project dates)
are in compliance with the requirements of Chapter 2258, Texas Government Code related to paying established
City of Fort Worth wage rates per the project bid documents. I further certify that no rebates or deductions have
been or will be made, directly or indirectly, from any wages paid in connection with this project, other than those
provided by law.
(Signature of Officer or Agent}
Sworn to and subscribed in mylpp,?sence this ((,I day of t �`ylV 207.
J//J'� .
C) �QRY P�&r
OF
�}Q
�c+••.'.J555!°:��p \�:' (Notary Public)
Revised 3/08/2024
Affidavit of All -Bills -Paid
05/07/2026
RE: 25-0107 — PW 2025 Concrete Restoration Contract 4, Project no. 106091
STATE OF TEXAS §
THE COUNTY OF DALLAS §
Before me, the undersigned, on this :-L day of tray , 2026, personally
appeared ASNhj±I 6AG471 of Vernara LLC (hereinafter referred to as "Contractor"),
known by me to be a credible person, and who, being duly sworn, upon oath stated
and affirmed that any and all bills incurred for the referenced project to the
Contractor have been paid in full or as independently agreed upon. This includes, but
is not limited to:
Labor, material, rentals, and any other related services or products purchased for the
usage in the referenced project.
CONTRACTOR:
ASNkA+S mice r — CC-C,
(Name & Title)
of Vernara LLC
(Signature)
0+1 ZaZb
(Date)
BEFORE ME, the undersigned authority, this day personally appeared
A-�hI m &hek and on oath stated that the facts hereinabove stated are true to
the best of his/her knowledge or belief.
Notary Public in and for the state of T7\'i45
My commission expires: 0 3
CONSENT OF SURETY
TO FINAL PAYMENT
Conforms with the American Institute of
Architects, AIA Document G707
TO OWNER:
(Name and address)
City of Fort Worth
100 Fort Worth Trail,
Fort Worth, TX 76102
PROJECT:
(Name and address)
2025 Concrete Restoration Contract 4
City Project No. 106091
Bond No: 77459
OWNER
❑
ARCHITECT
❑
CONTRACTOR
SURETY
RX
OTHER
❑
ARCHITECT'S PROJECT NO.:
CONTRACTFOR: OCP: $2,149,660.00
FCP: $2,537,300.00
CONTRACT DATED: June 10, 2025
In accordance with the provisions of the Contract between the Owner and the Contractor as indicated above, the
(Insert name and addressofSurety)
Western National Mutual Insurance Company
PO BOX 1463,
Minneapolis, MN 55440
,SURETY,
on bond of
(Insert name and address of Contractor)
Vernara LLC
17250 Dallas Pkwy,
Dallas, TX 75248
,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
(Insert name and address of Owner)
City of Fort Worth
100 Fort Worth Trail,
Fort Worth, TX 76102
OWNER,
as set forth in said Surety's bond.
IN WITNESS WHEREOF, the Surety has hereunto set its hand on this date: April 30, 2026
(Insert in writing the month . followed by the numeric date and year.)
Attest:
Crosby Guercio
Western National Mutual Insurance Comoan
(Surety)
(Signature of authorise representative)
Sean McCauley, Jr. _ Atforrey-in-Fact
(Printed name and title)
S-21341GE 10101
XDP
WESTERN NATIONAL
7rir• mlatiowwp company
POWER OF ATTORNEY
KNOW ALL MEN BY THESE PRESENTS: That Western National Mutual Insurance Company, a Minnesota mutual insurance company, does
make, constitute, and appoint: Sean McCauley, Jr., Bridget Truxillo, Jarrod Yost
Sam Duckett, Sarah Timmons, Ashlyn Simchik. Liam Hackett
Its true and lawful Attorney(s)-in-Fact, with full power and authority for and on behalf of the Company as surety, to execute and deliver and affix the
seal of the Company thereto (if a seal is required) bond, undertakings recognizances or other written obligations in the nature thereof, (other than
bail bonds, bank depository bonds, mortgage deficiency bonds, mortgage guaranty bonds, guarantees of installment paper and note
guaranty bonds, self-insurance workers compensation bonds guaranteeing payment of benefits, hazardous waste remediation bonds or
black lung bonds), as follows:
All written instruments in an amount not to exceed an aggregate of Seven Million Five Hundred Thousand and 00/100 Dollars ($7,500,000.00) for any
single obligation, regardless of the number of instruments issued for the obligation.
and to bind Western National Mutual Insurance Company thereby, and all of the acts of said Attorneys -in -Fact, pursuant to these presents, are
ratified and confirmed. This appointment is made under and by authority of the board of directors at a meeting held on September 28, 2010. This
Power of Attorney is signed and sealed by facsimile under and by the authority of the following resolutions adopted by the board of directors of
Western National Mutual Insurance Company on September 28, 2010:
RESOLVED that the president, any vice president, or assistant vice president in conjunction with the secretary or any assistant secretary,
may appoint attorneys -in -fact or agents with authority as defined or limited in the instrument evidencing the appointment in each case, for
and on behalf of the company to execute and deliver and affix the seal of the Company to bonds, undertakings, recognizances, and
suretyship obligations of all kinds, and said officers may remove any such attorney -in -fact or agent and revoke any Power of Attorney
previously granted to such person.
RESOLVED FURTHER that any bond, undertaking, recognizance, or suretyship obligation shall be valid and binding upon the Company
(i) when signed by the president, any vice president or assistant vice president, and attested and sealed (if a seal be required) by any
secretary or assistant secretary; or
(ii) when signed by the president, any vice president or assistant vice president, secretary or assistant secretary, and countersigned and
sealed (if a seal be required) by a duly authorized attorney -in -fact or agent; or
(iii) when duly executed and sealed (if a seal be required) by one or more attorneys -in -fact or agents pursuant to and within the limits of
the authority evidenced by the Power of Attorney issued by the Company to such person or persons.
RESOLVED FURTHER that the signature of any authorized officer and the seal of the company may be affixed by facsimile to any Power
of Attorney or certification thereof authorizing the execution and delivery of any bond, undertaking, recognizance, or other suretyship
obligations of the Company; and such signature and seal when so used shall have the same force and effect as though manually affixed.
IN WITNESS WHEREOF, Western National Mutual Insurance Company has caused these presents to be signed by its proper officer and
its corporate seal to be affixed this _5th day of December, 2023.
A, �
�.SEAL;�b
Jennifer A. Young, Secretary Mark S. Hewitt, Vice President, Surety
STATE OF MINNESOTA, COUNTY OF HENNEPIN
On this 5th day of December, 2023, personally came before me, Jennifer A. Young and Mark S. Hewitt and to me known to be the
individuals and officers of the Western National Mutual Insurance Company who executed the above instrument, and they each acknowledged
the execution of the same, and being by me duly sworn, did severally dispose and say; that they are the said officers of the corporation aforesaid,
and that the seal affixed to the above instrument is the seal of the corporation, and that said corporate seal and their signatures as such officers
were duly affixed and subscribed to the said instrument by the authority of the board of directors of said corporation.
ETA
�y tinr�omre.ers,r
Deena Anjali Entrikin, Notary Public
My commission expires January 31, 2029
CERTIFICATE
I, the undersigned, Secretary of the Western Natio.n.Dl Mutual Insurance Company, a Minnesota corporation, CERTIFY that the foregoing and
attached Power of Attorney remains in full force and, been revoked; and furthermore, that the Resolutions of the board of directors set forth
in the Power of Attorney, are now in force:
SEAL;
WS
41
Signed and sealed at the City of Edina, MN this 30th day of April 2026 Jennifer A. Young, Secretary """
FORT WORTH.
TRANSPORTATION AND PUBLIC WORKS
May 28, 2026
Vernara, LLC
17250 Dallas Parkway
Dallas, Tx 75248
RE: Acceptance Letter
Project Name: 2025 Concrete Restoration Contract 4
Project Type: Paving
City Project No.: 106091
To Whom It May Concern:
On April 24, 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 1, 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 1, 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 682-
444-8921.
Sincerely,
Otuyelu, Iretomiwa S, Project Manager eto�y Otuyelu (Jun 29, 20261557:36 CDT)
Zelalem Arega, Program Manager
Zu41th AM
Zelalem Arega (Jun 29, 2026 16:50:01 CDT)
Cc: Brandon Gibson, Inspector
Mike Glover, Inspection Supervisor
Randy Horton, Senior Inspector
Zelalem Arega, Program Manager
City of Fort Forth, Consultant
Vernara, Inc. , Contractor
NA, Developer
File
E-Mail: TPW_Acceptance@fortworthtexas.gov
Rev. 8/20/19