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HomeMy WebLinkAbout064369-FP1 - Construction-Related - Contract - Venus Construction Company-FP1 City Secretary Contract No. 64369 FORT WORTH® Date Received 7/15/2026 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: Millie Cole City Project No.: 106307 Improvement Type(s): Water 0 Sewer 0 Original Contract Price: $892,572.00 Amount of Approved Change Order(s): -$3,428.00 Revised Contract Amount: $889,144.00 Total Cost of Work Complete: $889,144.00 (7r� tM A. Raw Juan A. Ramos (Jul 15. 2026 09:56:16 CDT) Contractor Project Manager Title Venus Construction Company Company Name Mica erkins (Jul 15, 2026 10:22:21 CDT) Project Inspector ►Wa T Project Manager CFA Manager OfQ..rt.«. / rc:.uti Lauren Prieur (Jul 15, 2026 14:12:34 CDT) TPW Director 07/15/2026 Date 07/15/2026 Date 07/15/2026 Date 07/15/2026 Date 07/15/2026 Date OFFICIAL RECORD CITY SECRETARY Page 1 of 2 FT. WORTH, TX Notice of Project Completion Project Name: Millie Cole City Project No.: 106307 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: 60 WD Days Charged: 68 WD Work Start Date: 1/20/2026 Work Complete Date: 5/282026 Completed number of Soil Lab Test: 55 Completed number of Water Test: 12 Page 2 of 2 FORT WORTH CITY OF FORT WORTH FINAL PAYMENT REQUEST Contract Name MILLIE COLE Contract Limits Project Type WATER & SEWER City Project Numbers 106307 DOE Number 6307 Estimate Number 1 Payment Number 1 For Period Ending 5/28/2026 WD City Secretary Contract Number Contract Date Project Manager NA Contractor VENUS CONSTRUCTION COMPANY 1426 S. MAIN P O BOX 90 MANSFIELD, TX 76063 Inspectors M. GLOVER / M. PERKINS Contract Time 6WD Days Charged to Date 68 Contract is 100.00 Complete Friday, May 29, 2026 Page 1 of 5 City Project Numbers 106307 Contract Name MILLIE COLE Contract Limits Project Type WATER & SEWER Project Funding UNIT I: WATER IMPROVEMENTS Item Description of Items Estimated Unit No. Quanity 1 8" WATER PIPE 36 LF 2 2" WATER SERVICE 1 EA 3 6" GATE VALVE 2 EA 4 8" GATE VALVE 2 EA 5 12" GATE VALVE(CO#1) 7 EA 6 12" PVC WATER PIPE 1614 LF 7 3" WATER METER AND VAULT 2 EA 8 12" CUT -IN GATE VALVE 1 EA 9 DUCTILE IRON WATER FITTINGS W/ 4.32 TN RESTRAINT 10 CONNECTION TO EXISTING 4"-12" WATER 1 EA 11 4"-12" PRESSURE PLUG 1 EA 12 TRENCH SAFETY(CO#2) 2218 LF 13 FIRE HYDRANT 1 EA 14 3" WATER SERVICE 20 LF 15 POLY PIG 3 EA 16 2" SURFACE MILLING 178 SY 17 ASPHALT PVMT REPAIR BEYOND DEFINED 178 SY WIDTH, RESIDENTIAL 18 12" WATER PIPE, CSS BACKFILL 295 LF 19 12" WATER PIPE, CSLM BACKFILL 9 LF 20 24" CASING BY OPEN CUT(CO#2) 288 LF 21 24" CASING BY OTHER THAN OPEN CUT 153 LF 22 12" WATER CARRIER(CO#2) 548 LF 23 TRAFFIC CONTROL 1 MO Sub -Total of Previous Unit UNIT II: SANITARY SEWER IMPROVEMENTS DOE Number 6307 Estimate Number 1 Payment Number 1 For Period Ending 5/28/2026 Unit Cost Estimated Completed Completed Total Quanity Total $150.00 $5,400.00 36 $5,400.00 $4,653.00 $4,653.00 1 $4,653.00 $1,825.00 $3,650.00 2 $3,650.00 $2,510.00 $5,020.00 2 $5,020.00 $5,150.00 $36,050.00 7 $36,050.00 $150.00 8242,100.00 1614 $242,100.00 $30,000.00 $60,000.00 2 $60,000.00 $20,000.00 $20,000.00 1 $20,000.00 $15,000.00 $64,800.00 4.32 $64,800.00 $1,000.00 $1,000.00 1 $1,000.00 $500.00 $500.00 1 $500.00 $1.00 $2,218.00 2218 $2,218.00 $5,020.00 $5,020.00 1 $5,020.00 $215.00 $4,300.00 20 $4,300.00 $150.00 $450.00 3 $450.00 $101.00 $17,978.00 178 $17,978.00 $66.00 $11,748.00 178 $11,748.00 $109.00 $32,155.00 295 $32,155.00 $156.00 $1,404.00 9 $1,404.00 $295.00 $84,960.00 288 $84,960.00 $890.00 $136,170.00 153 $136,170.00 $188.00 $103,024.00 548 $103,024.00 $1,772.00 $1,772.00 1 $1,772.00 $844,372.00 $844,372.00 Item Description of Items Estimated Unit Unit Cost Estimated Completed Completed No. Quanity Total Quanity Total 1 3339.1001 4' MANHOLE 1 EA $24,300.00 $24,300.00 1 $24,300.00 Friday, May 29, 2026 Page 2 of 5 City Project Numbers 106307 Contract Name MILLIE COLE Contract Limits Project Type WATER & SEWER Project Funding 2 3305.0112 CONCRETE COLLAR FOR MANHOLE 1 EA 3 3331.4115 8" SEWER PIPE 16 LF 4 3305.0109 TRENCH SAFETY 16 LF 5 3301.0101 MANHOLE VACUUM TESTING 1 EA 6 3339.0001 EPDXY MANHOLE LINER 6 VF 7 3301.0002 POST -CCTV INSPECTION 16 LF 8 3301.0004 FINAL MH-CCTV INSPECTION 1 EA 9 9999.0011 COVER & RINGS W/ WATERTIGHT 1 EA GASKETS 10 3471.0001 TRAFFIC CONTROL 1 MO Sub -Total of Previous Unit DOE Number 6307 Estimate Number 1 Payment Number 1 For Period Ending 5/28/2026 $1,000.00 $1,000.00 1 $1,000.00 $750.00 $12,000.00 16 $12,000.00 $5.00 $80.00 16 $80.00 $500.00 $500.00 1 $500.00 $500.00 $3,000.00 6 $3,000.00 $35.00 $560.00 16 $560.00 $560.00 $560.00 1 $560.00 $1,000.00 $1,000.00 1 $1,000.00 $1,772.00 $1,772.00 1 $1,772.00 $44,772.00 $44,772.00 Friday, May 29, 2026 Page 3 of 5 City Project Numbers 106307 Contract Name MILLIE COLE Contract Limits Project Type WATER & SEWER Project Funding Contract Information Summary Original Contract Amount Change Orders Change Order Number 1 Change Order Number 2 Total Contract Price DOE Number 6307 Estimate Number 1 Payment Number 1 For Period Ending 5/28/2026 $892,572.00 $5,150.00 ($8,578.00) $889,144.00 Total Cost of Work Completed $889,144.00 Less % Retained $0.00 Net Earned $889,144.00 Earned This Period $889,144.00 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 $889,144.00 Friday, May 29, 2026 Page 4 of 5 City Project Numbers 106307 Contract Name MILLIE COLE Contract Limits Project Type WATER & SEWER Project Funding Project Manager NA Inspectors M. GLOVER / M. PERKINS Contractor VENUS CONSTRUCTION COMPANY 1426 S. MAIN P O BOX 90 MANSFIELD, TX 76063 DOE Number 6307 Estimate Number 1 Payment Number 1 For Period Ending 5/28/2026 City Secretary Contract Number Contract Date Contract Time 60 WD Days Charged to Date 68 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 $889,144.00 Less % Retained $0.00 Net Earned $889,144.00 Earned This Period $889,144.00 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 $889,144.00 Friday, May 29, 2026 Page 5 of 5 REVIEWED Lay Madiha Alshammry at 3:46 pm, Feb 11, 2026 DEVELOPER -AWARDED -PROJECT CHANGE ORDER PROJECT NAME: MILLIE COLE CHANGE CONTRACT: WATER & SANITARY SEWER IMPROVEMENTS ORDER No: CFA# 25-0136 I CITY PARTICIPATION: NO CITY PROJECT # 106307 CITY SECRETARY CONTRACT # 64369 FIG # 30114-0200431.106307-E07685 1 X# 28619 FILE # WA INSPECTOR: Brant Babb Phone No: 682-210-9772 PROJECT MANAGER: Madiha Alshammry Phone No: 817-980-3100 CONTRACT UNIT WORKING DAYS WATER SEWER DRAINAGE PAVING STREET LIGHTS Developer Cost City Cost Developer Cost City Cost Developer Cost City Cost Developer Cost City Cost Developer Cost City Cost ORIGINAL CONTRACT 5847,800.00 $0.00 $44,772.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 60 EXTRAS TO DATE $0.00 $0.00 $0.00 50.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 CREDITS TO DATE $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 CONTRACT TO DATE $847,800.00 $0.00 $44,772.00 $0.00 $0.00 $000 $0.00 $0.00 $0.00 $0.00 0 AMOUNT OF PROP. CHANGE ORDER $5,150.00 $0.00 $0.00 $0.00 10.00 $0.00 $0.00 $0.00 $0.00 50.00 0 REVISED CONTRACT AMOUNT $852950.00 $0.00 $41772.00 $0.00 $0.00 $0.00 $0.00 50.00 $0.00 $0.00 0 TOTAL REVISED CONTRACT AMOUNT PER UNIT $852,950.00 $44,772.00 $0.00 $0.00 $0.00 REVISED COST SHARE Dev. Cost: $897,722.00 City Cost: $0.00 TOTAL REVISED CONTRACT $897,722.00 Revised: 12-17-2018 Page 1 REVIEWED By Madiha Alshammry at 3:46 pm, Feb 11, 2026 You are directed to make the following changes in the contract documents: I I CITY BID ITEI.I I I I CFW Unit I I Developer I I I TOTAL UNIT I: WATER IMPROVEMENTS $5,150.00 0.00 $5,150.00 Asterisk (') indicates New Pay Item Revised: 12-17-2018 Page 2 REASONS FOR CHANGE ORDER Contractor is requesting 1-12" Gate Valve to reconcile with approved plans. REVIEWED By Madiha Alshammry at 3:46 pm, Feb 11, 2026 RECOMMENDED: APPROVED: APPROVED: Amanda Mata (Developer) (Contractor) J f j-1'-- By: (` �c�2/11/2026 Date: 2/10/2026 By: y'7�`— Date: By: Date: 2/11/2026 Name: Amanda Mata Name: John Wensinger Name: Juan A. Ramos Title: Project Manager Title: President Title: Project Manager APPROVAL RECOMMENDED: APPROVED: APPROVED AS TO FORM AND LEGALITY: CFW - Water Department CFW - Assistant City Manager CFW - Assistant City Attorney By: Not Applicable Date: By: Not Applicable Date: By: Not Applicable Date: Name: Not Applicable Name: Not Applicable Name: Not Applicable Tile: Not Applicable Title: Not Applicable Title: Not Applicable RECOMMENDED: CFW-'Contract Compliance Manager ATTEST • Contract Compliance Manager (Project Manager): %yp,/�,rQQd/yty 2/11/2026 By signing I acknowledge that I am the person responsible By: tn.. Date: for the monitoring and administration of this contract, 17 By: Not Applicable Date: and ensuring all performance and reporting requirements. Name: Madiha Alshammry Name: Jannelte S. Goodall 9 There are NO City Funds associated with this Contract Title: (rFW PM Tile: City Secretary OThere are City Funds associated with this Contract M&C Number: N/A M&C Date Approved: WA Revised: 12-17-2018 Page 3 REVIEWED By Madiha Alshammry at 9:56 am, Feb 19, 2026 DEVELOPER -AWARDED -PROJECT CHANGE ORDER PROJECT NAME: MILLIE COLE CHANGE CONTRACT: WATER & SANITARY SEWER IMPROVEMENTS ORDER No: CFA# 25-0136 I CITYPARTICIPATION: NO CITY PROJECT# 106307 CITY SECRETARY CONTRACT# 64369 FID # 30114-0200431-106307-E07685 2 X# 28619 FILE # N/A INSPECTOR: Brant Babb Phone No: 682-210-9772 PROJECT MANAGER: Madiha Alshammry Phone No 817-980-3100 CONTRACT UNIT WORKING DAYS WATER SEWER DRAINAGE PAVING STREET LIGHTS Developer Cost CityCoot DeveloperCoot Cit Cost Developer Cost Cl Coat Developer Cool OltyCost Developer Cost CityCoot ORIGINAL CONTRACT $847,800.00 ' $0.00 $44,772.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 60 EXTRAS TO DATE $6,160.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 CREDITS TO DATE $0.00 $0.00 $0.00 $0.00 $0.00 $000 $0.00 $0.00 $0.00 $0.00 CONTRACT TO DATE $852,950.00 $0.00 $44,772.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 0 AMOUNT OF PROP. CHANGE ORDER :L.V) $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 00.00 $0.00 $0.00 0 REVISED CONTRACT AMOUNT 5844,372.00 $0.00 $44,772.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $4.00 0 TOTAL REVISED CONTRACT AMOUNT PER UNIT $844,372.00 $44,772.00 $0.00 $0.00 $0.00 REVISED COST SHARE Den. Cost: $889,144.00 City Cost: $0.00 TOTAL REVISED CONTRACT $889,144.00 Revised: 12-17-2018 Page 1 REVIEWED By Mad/ha Alshammry at 9:56 am, Feb 19, 2026 You are directed to make the following changes in the contract documents. UNIT I, WATFR IMPRf1VFMFMTA PAY ITEM 6 CITY BID ITEM A QUANTITY UNIT CFW Unit ITEM DESCRIPTION Price UNIT PRICE Developer Cost City Cost TOTAL 12 3305,0109 3.000 LF Trench Safety $1.00 $3.00 $0.00 $3.00 20 3305.1004 (31.00) LF 24" Casing by Open Cut $295.00 ($9,14500) $0.00 ($9,145.00) 22 3305.2004 3.00 LF 12" Water Carrier $188.00 $564.00 $0.00 $564.00 TOTAL UNIT: WATER IMPROVEMENTS (S8 578.00) 50.00 ($8,578.00) Asterisk (*) Indicates New Pay Item Revised: 12-17-2O18 Page 2 REVIEWED By Mad/ha Alshammry at 9:56 am, Feb 19, 2026. REASONS FOR CHANGE ORDER RECOMMENDED: The 12' Waterline tie-in location and flow/me updated to reconcile with site conditions. Proposed 12' WL will now go above existing sewer and no longer require steel casing from station 0+09.82 to 0+70.87. Changes correspond to Revision I shown on sheet 7. APPROVED: APPROVED: Amanda Mata (Developer) (Contractor) By; iscA#9 Date: 2/18/2026 By: C� ~- Date: 2/19/26 By: � Date: 2/19/2026 Name: Amanda Mt e Name: John Wensinger Name: Juan A. Ramos Title: Project Manager Title: President Title: Protect Manager APPROVAL RECOMMENDED: APPROVED: APPROVED AS TO FORM AND LEGALITY: CFW - Water Department CFW - Assistant City Manager CFW - Assistant City Attorney By: Not Applicable Date: By: Not Applicable Date: By: Not Applicable Date: Name: Not Applicable Name: Not Applicable Name: Not Applicable Title: Not Applicable Title: Not Applicable Title: Not Applicable RECOMMENDED: CFW - 'Contract Compliance Manager ATTEST • Contract Compliance Manager (Project Manager): 2/19/2026 By signing I acknowledge that I am the person responsible By, Date: for the monitoring and administration of this contract, By: Not Applicable Date: and ensuring all performance and reporting requirements. Name: Madiha Alshammry CoFW PM Name: Janette S. Goodall EjThere are NO City Funds associated with this Contract Title: Title: City Secretary ❑There are City Funds associated with this Contract M&C Number N/A M&C Date Approved: N/A Revised: 12-17-2018 Page 3 FORT WORTH TRANSPORTATION AND PUBLIC WORKS PIPE REPORT FOR: PROJECT NAME: Water & Sanitary Sewer Improvements To Serve Millie Cole CITY PROJECT NUMBER: 106307 WATER PIPE LAID SIZE TYPE OF PIPE LF C900 8" PVC 36' C900 12" PVC 1,614' FIRE HYDRANTS: 1 VALVES (16" OR LARGER) PIPE ABANDONED SIZE TYPE OF PIPE LF DENSITIES: PASSED NEW SERVICES: 3" copper 20' SEWER PIPE LAID SIZE TYPE OF PIPE LF SDR26 8" PVC 16' PIPE ABANDONED SIZE TYPE OF PIPE LF DENSITIES: PASSED NEW SERVICES: TRANSPORTATION AND PUBLIC WORKS The City of Fort Worth • 1000 Throckmorton Street • Fort Worth, TX 76012-6311 FORT WORTH® TRANSPORTATION AND PUBLIC WORKS May 28, 2026 Venus Construction 1426 S. Main Mansfield, Tx 76063 RE: Acceptance Letter Project Name: Water & Sanitary Sewer Improvements To Serve Millie Cole Project Type: Water & Sanitary Sewer City Project No.: 106307 To Whom It May Concern: On May 27, 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 28, 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 28, 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- 392-7252. Sincerely, Madiha Alshammry, Project Manager Cc: Mike Perkins, Inspector Mike Glover, Inspection Supervisor Randy Horton, Senior Inspector Andrew Goodman, Program Manager Westwood Professional Services, Consultant Venus Construction, Contractor Willmax FW- Multifamily, L.P., Developer File E -Mail: TPW_Acceptance@fortworthtexas.gov Rev.8/20/19 AFFIDAVIT STATE OF Texas COUNTY OF Johnson Before me, the undersigned authority, a notary public in the state and county aforesaid, on this day personally appeared Matt Petry , Vice President Of Venus Construction Company, 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; Millie Cole CON -25-0193 Subscribed and sworn before me on this date 24th of June, 2026. Notary Public Se• t -e County, State J Dh 1'� �r[7Y� CD CONSENT OF SURETY To: WiliMax FW Multi -Family, L.P. and the City of Fort Worth Project: Millie Cole Contract No.: CFA Number 10637 Contract Date: November 5th, 2025 Contractor: Venus Construction Company, Inc. Bond Number: 46BCSJJ5695 Hartford Fire Insurance Company (hereinafter "Surety"), as surety for Venus Construction Company. Inc , the principal on the above referenced performance and payment bonds, hereby consents and agrees to (check appropriate box or boxes): ❑ The amount of the performance bond and payment bond referenced above being increased from $ (original Bond amount) to ❑ The issuance of progress payment No. to Contractor in the amount of ❑ The reduction in the amount of retainage held under the Contract from to © Final payment of$889,144.00 889,144.00 , or any part thereof being paid to Contractor. All other terms and conditions of the above -referenced performance bond and payment bond shall remain unchanged and in full force and effect. IN WITNESS WHEREOF, the Surety has set its hand this 24th day of June, 2026 Hartford Fire Insurance Comnan By:e'4,/. Lloyd R Pitts, ttorney-In-Fact Direct Inquiries, Bond Authenticity POWER OF ATTORNEYand Claims to: THE HARTFORD BOND, T-14 One Hartford Plaza Hartford, Connecticut 06155 Bond.Claims@Jthehartford corn call. 888-266-3488 or fax: 860-757-5835 KNOW ALL PERSONS BY THESE PRESENTS THAT: Agency Name: PITTS FENNELL & ASSOCIATES LLC Agency Code: 46-508944 Hartford Fire Insurance Company, a corporation duly organized under the laws of the State of Connecticut Hartford Casualty Insurance Company, a corporation duly organized under the laws of the State of Indiana Hartford Accident and Indemnity Company, a corporation duly organized under the laws of the State of Connecticut ❑ Hartford Insurance Company of the Midwest, a corporation duly organized under the laws of the State of Indiana having their home office in Hartford, Connecticut, (hereinafter collectively referred to as the "Companies") do hereby make, constitute and appoint, up to the amount of Unlimited: Lloyd R. Pitts, Jordan A. Pitts of Rowlett, Texas their true and lawful Attorney(s)-in-Fact, each in their separate capacity if more than one is named above, to sign its name as surety(ies) only as delineated above by ®, and to execute, seal and acknowledge any and all bonds, undertakings, contracts and other written instruments in the nature thereof, on behalf of the Companies in their business of guaranteeing the fidelity of persons, guaranteeing the performance of contracts and executing or guaranteeing bonds and undertakings required or permitted in any actions or proceedings allowed by law. In Witness Whereof. and as authorized by a Resolution of the Board of Directors of the Companies on May 23, 2016 the Companies have caused these presents to be signed by its Assistant Vice President and its corporate seals to be hereto affixed, duly attested by its Assistant Secretary. Further, pursuant. to Resolution of the Board of Directors of the Companies, the Companies hereby unambiguously affirm that they are and will be bound by arty mechanically applied signatures applied to this Power of Attorney. _ - -` ° F' • SU'•., ,� 5, 70 INgUo_. ' w "gip cDM11p ,-p.� - � - , �- -H�� :.�_ � AAGFa ;DNglr•Q ant ..� •, _�.'ccgariPODgrFO m_ .% v•...�_. _ @y••• ::03 ~dy. rlrmmlP :aa ..,� mss' 1979 f� _ n -_ _ - : �Fi0RAIi0rlffll ttll`tvl_-,..•r'v.` / rrf `t15.. Phyllis A. Clark, Assistant Secretary Joelle L. LaPierre, Assistant Vice President STATE OF FLORIDA 55. Lake Mary COUNTY OF SEMINOLE On this 1st day of March, 2024, before me personally came Joelle L. LaPierre, to me known, who being by me duly sworn, did depose and say: that (s)he resides in Seminole County, State of Florida that (s)he is the Assistant Vice President of the Companies, the corporations described in and which executed the above instrument; that (s)he knows the seals of the said corporations; that the seals affixed to the said instrument are such corporate seals, that they were so affixed by authority of the Boards of Directors of said corporations and that (s)he signed his/her name thereto by like authority. Mariluz Arce My Commission HH 287363 Expires July 13, 2026 I, the undersigned, Assistant Vice President of the Companies, DO HEREBY CERTIFY that the above and foregoing is a true and correct copy of the Power of.Attomney executed by said Companies, which is still in full force effective as of June 24th. 2026 Signed and sealed in Lake Mary, Florida. ogre,, urnf �i� ,aOF1RErIrySG•,, .��poyINSp9�.,, .�sau,ewrirvr.,, ` ,,�a�� ' ,. of cDM1lp jpq'•"'C0RP0R7r"'•':�d`% _ nl d4`J.' NPOR cam' J _ •• _ , Z • ••O F ✓b. rxm ntrP :aa r--�^ - z i 1 �J.•\ —✓ tom• 6.•.'•...........� 6'+. 99 ��� ! "4rtm na`P h/DIPHP O Keith D. Dozois, Assistant Vice President Have a complaint or need help? If you have a problem with a claim or your premium, call your insurance company or HMO first. If you can't work out the issue, the Texas Department of Insurance may be able to help. Even if you file a complaint with the Texas Department of Insurance, you should also file a complaint or appeal through your insurance company or HMO. If you don't, you may lose your right to appeal. The Hartford To get information or file a complaint with your insurance company or HMO: Call: Consumer Affairs at 1-800- 451-6944 Toll -free: 1-800-451-6944 Email: bond.claims@thehartford.com Mail: The Hartford Financial Services One Hartford Plaza, T-14 Hartford, CT 06155 Attn: Bond Claims Department The Texas Department of Insurance To get help with an insurance question or file a complaint with the state: Call with a question: 1-800-252-3439 Email: ConsumerProtection@tdi.texas.gov File a complaint: www.tdi.texas.gov Mail: MC 111-1A, P.O. Box 149091, Austin, TX 78714-9091