Loading...
HomeMy WebLinkAbout060708-A1FP1 - Construction-Related - Contract - Trophy Construction Services, LLCFORT WORTH® -FP1 City Secretary Contract No. 60708 -Al Date Received 9/15/2026 I_'I 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: Azalea Avenue Townhomes City Project No.: 104341 Improvement Type(s): Water ❑x Sewer ❑x Developer Cost City Cost Total Cost Original Contract Price: Water $166,706.35 $0.00 $166,706.35 Original Contract Price: Sewer $129,534.14 $79,576.34 $209,110.48 Amount of Approved Change Order(s): Water -$4,124.93 $0.00 -$4,124.93 Amount of Approved Change Order(s): Sewer $26,704.92 -$3,154.05 $23,550.87 Revised Contract Amount: Water $162,581.42 $0.00 $162,581.42 Revised Contract Amount: Sewer $156,239.06 $76,422.29 $232,661.35 Total Cost of Work Complete: $318,820.48 $76,422.29 $395,242.77 Contractor PM Title Trophy Construction Services Company Name Project Inspector Andrew Goodman Project Manager 09/14/2026 Date 09/14/2026 Date 09/14/2026 Date OFFICIAL RECORD CITY SECRETARY FT. WORTH, TX Page 1 of 2 CFA Manager Lauren Prieur (Sep 15, 2026 14:44:26 CDT) TPW Director Notice of Project Completion Project Name: Azalea Avenue Town homes City Project No.: 104341 City's Attachments Final Pay Estimate ❑x Change Order(s): ❑x Yes ❑ N/A Pipe Report: ❑x Yes ❑ N/A Date 09/15/2026 09/15/2026 Date Contractor's Attachments Affidavit of Bills Paid Consent of Surety Statement of Contract Time Contract Time: 80 WD Days Charged: 207 WD Work Start Date: 7/10/2025 Work Complete Date: 12/8/2025 Completed number of Soil Lab Test: 53 Completed number of Water Test: 8 Page 2 of 2 FoRT WFORT WORTH CITY OF FORT WORTH FINAL PAYMENT REQUEST Contract Name AZALEA AVENUE TOWNHOMES Contract Limits Project Type WATER & SEWER City Project Numbers 104341 DOE Number 4341 Estimate Number I Payment Number 1 City Secretary Contract Number Contract Date For Period Ending 12/8/2025 WD Project Manager NA Contractor TROPHY CONSTRUCTION SERVICES LLC 236 E. ELLISON STREET BURLESON, TX 76028 Inspectors M.GLOVER / C. FUENTES Contract Time 8WD Days Charged to Date 207 Contract is 100.00 Complete Wednesday, December 10, 2025 Page 1 of 5 City Project Numbers 104341 Contract Name AZALEA AVENUE TOWNHOMES Contract Limits Project Type WATER & SEWER Project Funding UNIT I: WATER IMPROVEMENTS DOE Number 4341 Estimate Number 1 Payment Number 1 For Period Ending 12/8/2025 Item Description of Items Estimated Unit Unit Cost Estimated Completed Completed No. Quanity Total Quanity Total 1 SALVAGE 1" WATER METER (CO#2) 2 EA $500.00 $1,000.00 2 $1,000.00 2 8" WATER PIPE 671 LF $60.00 $40,260.00 671 $40,260.00 3 8" DIP WATER 40 LF $95.00 $3,800.00 40 $3,800.00 4 8" GATE VALVE 5 EA $4,350.00 $21,750.00 5 $21,750.00 5 1" DOMESTIC WATER SERVICE 35 EA $1,743.00 $61,005.00 35 $61,005.00 6 IMPORTED EMBEDMENT/BACKFILL, CSS I CY $275.00 $275.00 1 $275.00 7 DUCTILE IRON WATER FITTINGS 0.2 TN $10,823.00 $2,164.60 0.2 $2,164.60 8 CONNECTION TO EXISTING 4" - 12" WATER 3 EA $4,957.00 $14,871.00 3 $14,871.00 MAIN 9 8" WATERLINE LOWERING 2 EA $4,833.00 $9,666.00 2 $9,666.00 10 CONC PVMT REPAIR, RESIDENTIAL (CO#1) 2.9 SY $594.25 $1,723.32 2.9 $1,723.32 (CO#2) 11 TRENCH SAFETY 711 LF $1.50 $1,066.50 711 $1,066.50 12 TRAFFIC CONTROL 1 MO $5,000.00 $5,000.00 1 $5,000.00 Sub -Total of Previous Unit $162,581.42 $162,581.42 UNIT II: SANITARY SEWER IMPROVEMENTS Item Description of Items Estimated Unit Unit Cost Estimated Completed Completed No. Quanity Total Quanity Total 1 8" SEWER PIPE (CO#I) 57 LF $85.00 $4,845.00 57 $4,845.00 2 8" DIP SEWER PIPE (CO#1) 722 LF $96.28 $69,514.16 722 $69,514.16 3 4'MANHOLE 2 EA $5,406.00 $10,812.00 2 $10,812.00 4 4' SHALLOW MANHOLE 6 EA $5,711.00 $34,266.00 6 $34,266.00 5 4" SEWER SERVICE 35 EA $1,154.00 $40,390.00 35 $40,390.00 6 POST -CCTV INSPECTION(CO#1) 779 LF $2.50 $1,947.50 779 $1,947.50 7 MANHOLE VACUUM TESTING 8 EA $500.00 $4,000.00 8 $4,000.00 8 IMPORTED EMBEDMENT/BACKFILL, CSS 1 CY $275.00 $275.00 1 $275.00 9 CONCRETE ENCASEMENT FOR UTILITY PIPES 61 CY $440.79 $26,888.19 61 $26,888.19 (CO#1) 10 8" SEWER PIPE, CLSM BACKFILL 20 LF $78.50 $1,570.00 20 $1,570.00 11 TRENCH SAFETY(CO#1) 779 LF $1.50 $1,168.50 779 $1,168.50 12 CONC PVMT REPAIR, RESIDENTIAL 8 SY $594.25 $4,754.00 8 $4,754.00 Wednesday, December 10, 2025 Page 2 of 5 City Project Numbers 104341 Contract Name AZALEA AVENUE TOWNHOMES Contract Limits Project Type WATER & SEWER Project Funding DOE Number 4341 Estimate Number 1 Payment Number 1 For Period Ending 12/8/2025 13 TRAFFIC CONTROL 1 MO $3,500.00 $3,500.00 1 $3,500.00 14 SANITARY LINE GROUTING (CO#1) 46.00008 CY $560.26 $25,772.00 46.00008 $25,772.00 15 8" SEWER ABANDONMENT PLUG (CO#1) 1 EA $375.00 $375.00 I $375.00 16 REMOVE 8" SEWER LINE (CO#1) 76 LF $34.00 $2,584.00 76 $2,584.00 Sub -Total of Previous Unit $232,661.35 $232,661.35 Wednesday, December 10, 2025 Page 3 of 5 City Project Numbers 104341 Contract Name AZALEA AVENUE TOWNHOMES Contract Limits Project Type WATER & SEWER Project Funding Contract Information Summary Original Contract Amount Change Orders Change Order Number I Change Order Number I Change Order Number 2 Total Contract Price DOE Number 4341 Estimate Number 1 Payment Number 1 For Period Ending 12/8/2025 $375,816.83 ($2,377.00) $23,550.87 ($1,747.93) $395,242.77 Total Cost of Work Completed $395,242.77 Less % Retained $0.00 Net Earned $395,242.77 Earned This Period $395,242.77 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 $395,242.77 Wednesday, December 10, 2025 Page 4 of 5 City Project Numbers 104341 Contract Name AZALEA AVENUE TOWNHOMES Contract Limits Project Type WATER & SEWER Project Funding Project Manager NA Inspectors M.GLOVER / C. FUENTES Contractor TROPHY CONSTRUCTION SERVICES LLC 236 E. ELLISON STREET BURLESON, TX 76028 DOE Number 4341 Estimate Number 1 Payment Number 1 For Period Ending 12/8/2025 City Secretary Contract Number Contract Date Contract Time 80 WD Days Charged to Date 207 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 $395,242.77 Less % Retained $0.00 Net Earned $395,242.77 Earned This Period $395,242.77 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 $395,242.77 Wednesday, December 10, 2025 Page 5 of 5 r-1 O U cc N O (O O z U C/) U w (.7 Z O I- 0 w O 0 0 w 0 NQ LL w IL O J w w 0 w O (Dz Z w aw ID O r C,) w >- z O a U I- a - U 0 Q 4) (a 0 u) C4, to ti N 4) w CL w E o ai t c a 0 W O O N O 0 0 Q m M d n aD 4 W (4 , h N N LL 4t U I - z O U t O H Z F- 0 0 U U O Z Q 00 O J n� O O O LL X LL I- U) 'ct CV Q CD M CN M N co (o cc z° z° 0) 0) OL O OO W z Z Q U W O 0 zN ca co0 c co 00 U > o o 0 O 0 o 0 O 0 O 0 O (.. = J_J w 4, 4, w 4, 4, 0 o W y 0 0 CL o o 0W o o 0 0 w w w w U w w N N (o N- o U 0 0 0 00000 0 0 o CC v N w eon w W W 0 do o w o y 0 (0 0 D 0 o 0 w 0 0 0 0 0 0 y o w w 4,44 aU w w o O U o o 0 0 0 0 0 0 o o . O H �' w w w eon w w Z O 2 0 U no w m G C� z L 0 o 0 O 0 o 0 o 6 O 6 0 6 M eq o O d > m w w w w w w O U y 0 C 0 0 0 0 0 aa}} P1 (a N N OI O w O w N pj O 10 U w w w I-. M a w CDCD ao CD 3 CI) 0 0 r r N 0 N N U 4) p 440 N o O w o O w N N ° a ^ 0 of N N w a> w > eq W w N V0 0 0 0 0 0 0 0 0 0 0 0 U w w w w w w 0 U) N °' � o CD d O. o 0 N- 0 w p w 0 1'. C0" O C- N CI v w N U O > o w w N w (O w w 0 W a w t - O H o a w U 4 r- z F i z Z O U (0 I- 0 _ ¢ z z 0 w U w WO Q d H0 O U U a 0 O O CL 00 0 HH U O Z o N W W Q O z W H Z W J ~ U F w z O w > a O W U O Q w O O /to - 2 % )dcc G R////__m C > t "$©)24 - o o @g§48 /\ @ §)a( \$ ® _ 6S4 §7cC 72888 IL(A '-®aaQ mm_ u _ _ § ® {\ �• m 2tf.am22 i\ c® —)E § om°tG @�m m! >E=a`% NA co aw^EKE to d \3 %%b%b)-J eeR /\a o — » *3/ / §�) )k))//\ q- ® ° e —zzz $ 0 CJ / a w O w (7 z U O (I) z O ww 0 Ca ri m 2 0) a) 0) C II) V) 6 O I � (j \` CU I y U N O N O .-1 OO 0 C a) w CU 0)C Ca `= u Q IL. N O N 00 00 0 w 0 z w m g c c U CI m a0i > U o O E ui a Z j Q O .0 ^ y w U w o - E m 0)a° w to N m C m C 'v 0 m e O N O U N C O N to rnE C) w d r r L_o L `0 $. a C w L w CM m m C 0 0 m CU_ O a) a . w to m m L C C N U O w m E -`o w C w a C mw I -o a 0 rn a v E C =m C) U C 0 to 0 O) O 0) O j Z w C) w �'c E c m m n ¢ c m w w o to y'0 `w w Q U a 2 c r t i4 ❑ '❑ F L() N N t --I O0 O C w m t � m 0 U t0a m U) 4 a• ww I - E ai Q z � m Cfl N 0 N co I Ca 0 c m w m U N m tca I ≥I C 7 C O U E '0 y w U 0 C 0 (� w i --I a HIic w 1 OU E ai E WI zI i- Um z m 0 0 0 (D m U) a a) w Cl) C Q ¢ z z a -o w 0 E 0 Z an U ¢ as w U CO 06 I I C c w I— Cl) w CC co a co C) N N C— a) N 0 u co / d z U FM U }j 3/ N § \ a- 0 } ( / ) Ca k o ( e § of / w f \ § \ R = 7 § r ) \ 7 ( § { § 5 ( & z O \ HZH ° OO 8 & w ± } x,( 0 0 O O 00 0 o E x E Lfl k§ \ k § \ 00 zz O 0 & I-0(0 2 2O O O za O U U) ( j ) § } § § ° \ k � - - /\\�\�m ■ - § [ § § § § } 0 0 ° 4 6 CD ° 0_ . . . Ct). } ) 00 # qgj 0 ta, 0 } \ td \ / k td j § ) a ! m k R \ f N \ } \ 00o00 ; q § m ■ O § \ .- ) G CD !! ! 0. W § & § OF- 7 e K u\\ k O U) § w 2§! o B§ u § k k § § ( k 0§ 0 S! R m You are directed to make the following changes in the contract documents: UNIT I:_ WATER_ IMPROVEMENTS CITY BID ITEM PAY ITEM # QUANTITY UNIT ITEM DESCRIPTION CFW Unit UNIT PRICE Developer City Cost TOTAL # Price Cost I 1 241.1512 (1.00) EA I Salvage 1" Water Meter $0.00 I $500.00 $ (500.00) $ - ($500.00) 10 3201.0614 (2.10) SY Cone Pvmt Repair, Residential $135.00 $594.25 $ (1,247.93) ($1,247.93) TOTAL _UNIT _I: WATER IMPROVEMENTS S t1.747.93), $_ $ (1,747.93) Revised: 12-17-2018 Page 2 REASONS FOR CNANOE ORDER 11Daluaeeyco andm.Mt nollaiUE.d. NECOMMENDRO: APPROVED: APPROVED: SA MEEn�p(nllrinDOtouµPLLC Or, 1r1 No.. ___ •_!U n.. IVe3IRN fBuitlrnpEtC By. IroyMlyCbnlWd ISeAfl Dy. �✓ Nam.: Namo: Till. fCO�Ct' Av.ytr me- •D1ar1Q(L iv.: IA APPROVED: APPROVED; APPROVED: By: B% or.. Hama: Nam►: > 10/1925 ..:��: ) TN,: ill. _ TNo: APPROVAL RECOMMENDED: APPROVED: APPROVEDAS TO FORM ANDLEOALITYI CPWiundlrp D.p.Rmint CFWAuIU.m CiyAlaneper CrW-AiWlanl ClyANomly By By By film: Hama: Home: Till.: TN.: IN.: dG..l 10/13/2025 RECOMMENDEO: CPW-Cenl1.HConlpliance Alon.p.r ATTEST By Name: JEN.E18 Goodall gty8ecraluy TIYo: M&C Num0u: M.C Date App(aefd. • ConttaetCompllaece Manager (Profut Minfpn): By ,inn* I acuavdadp. that am Na poison Iasporuttto (or the moivIok. and administration of W. eovilEd. Wde anlmNg sit p.darmana and tcplNnp regVt.mnU. [] There am HO Clty Fuds.11odfled MINIAU Contract Q Then ero City ►undo associated MINI into Contract R.ns.d: 12-17.1010 Pape 0 10/02/2025 FORT WORTH TRANSPORTATION AND PUBLIC WORKS PIPE REPORT FOR: PROJECT NAME: Azelea Avenue Town Homes CITY PROJECT NUMBER: 104341 I WATER PIPE LAID SIZE TYPE OF PIPE LF PVC Water Line 8" C900 PVC 671. LF DIP Water Line 8" Ductile Iron 40. LF FIRE HYDRANTS: VALVES (16" OR LARGER) PIPE ABANDONED SIZE TYPE OF PIPE LF DENSITIES: All densities passed. NEW SERVICES: SEWER PIPE LAID SIZE TYPE OF PIPE LF 58. LF PVC Sewer Line 8" PVC. SDR-26 DIP Sewer Line, 8" Ductile Iron 742. LF TYPE OF PIPE LF PIPE ABANDONED SIZE DENSITIES: 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 December 8, 2025 Trophy Construction Services 236 E. Ellison Street Burleson, Texas 76028. RE: Acceptance Letter Project Name: Azalea Avenue Town Homes Project Type: Water & Sanitary Sewer City Project No.: 104341 To Whom It May Concern: On November 10, 2025 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 December 8, 2025. 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 December 8, 2025, 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- 392-6251. Sincerely, Andrew Goodman, Project Manager Cc: Cristobal Fuentes, Inspector Mike Glover, Inspection Supervisor Randy Horton, Senior Inspector Andrew Godman, Program Manager Shield Engineering, Consultant Trophy Construction Services, Contractor West River Homes Building, LLC, 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 not public in the state and county aforesaid, on this day personally appeared Wade Allard, VP Of Trophy Construction Services, LLC, known to me to be a credible person, who being by me duly sworn, upon his oath depose nd said; That all persons, firms, associations, corpor t ons, or other organizations furnishing labor and/or materials have een paid in full; That the wage scale established by the City C uncil in the City of Fort Worth has been paid in full; That there are no claims pending for property damages; On Contract described as; CPN 104341 Subscribed and sworn before me on this date 14th of Notary Pub r . ury and/or Wade Allard , 2026. -p°®� GINGER FRANKLIN MY COMMISSION EXPIRES OCTOBER 28, 2029 NOTARY ID: 12. 608646 CONSENT OF SURETY COMPANY TO FINAL PAYMENT AIA DOCUMENT G707 X395 OWNER ❑ ARCHITECT ❑ CONTRACTOR ❑ SURETY ❑ OTHER Bond No. 4467612 PROJECT: Underground Utilities (water/sewer/storm drain) to serve Azalea Avenue Townhomes, (name, address) CPN: 104341, CFA23-0055, Fort Worth, TX TO (Owner) [West River Homes and the City of Fort Worth ] ARCHITECT'S PROJECT NO: CONTRACT FOR: CONTRACT DATE: CONTRACTOR: Trophy Construction Services LLC 236 E. Ellison St. Burleson, TX 76028 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) SureTec Insurance Company 2103 CityWest Boulevard, Suite 1300 , Houston, TX 77042 SURETY COMPANY, on bond of (here insert name and address of Contractor) Trophy Construction Services LLC 236 E. Ellison St. Burleson, TX 76028 , CONTRACTOR, hereby approves of the final payment to the Contractors, and agrees that final payment to the Contractor shall not relieve the Surety Company of any of its obligations to (here insert name and address of Owner) West River Homes and the City of Fort Worth as set forth in the said Surety Company's bond. ,OWNER, IN WITNESS WHEREOF, the Surety Company has hereunto set its hand this 5th day of ' May 2Q25 Attest: ti " - (Seal): SureTec Insurance Company Surety Company Signature of Authorized Repres tative Sandra Lee Roney Attorney -In -Fact Title NOTE: This form is to be used as a eompaninn document to ALA DOCUMENT O706, CONTRACTOR'S AFFIDAVIT OF PAYMENT OF DEB'T'S AND CLAIMS, Current Edition AIA DOCUMENT O707 • CONSENT OF SURETY COMPANY TO FINAL PAYMENT • APRIL 1970 EDITION • AIAO p 1970 • THE AMERICAN INSTI T1JTL OT. ARCI-1I'fECT;S, 1735 New York Ave., NW, WASHINGTON, D.C. 20006 ONE PAGE POAU 4221756 JOINT LIMITED POWER OF ATTORNEY KNOW ALL MEN BY THESE PRESENTS: That SureTec Insurance Company, a Corporation duly organized and existing under the laws of the State of Texas and having its principal office in the County of Harris, Texas and Markel Insurance Company (the "Company"), a corporation duly organized and existing under the laws of the state of Illinois, and having its principal administrative office in Glen Allen, Virginia, does by these presents make, constitute and appoint: Debra Lee Moon, Sandra Lee Roney, Andrea Rose Crawford, Tray Russell Key, John R. Ward, Monica Ruby Veazey, Thomas Douglas Moore, Emily Allison Mikeska, Allyson W Dean, Colin E. Cooly, Bryan Kelly Moore, Andrew Gareth Addison, Elizabeth Ortiz, Patrick Thomas Coyle, Ana Owens, Faith Ann Hilty, Christopher Chase Carlisle, Frances Hartung, Stephanie Navarro, Brian P. Bordlee, Ross Las, Cary Kiper, Kimberly R. Gonzalez, Mark Adams, Crystal Langhorn, Steven W. Lewis Their true and lawful agent(s) and attorney(s)-in-fact, each in their separate capacity if more than one is named above, to make, execute, seal and deliver for and on their own behalf, individually as a surety or jointly, as co -sureties, and as their act and deed any and all bonds and other undertaking in suretyship provided, however, that the penal sum of any one such instrument executed hereunder shall not exceed the sum of: In Unlimited Amounts This Power of Attorney is granted and is signed and sealed under and by the authority of the following Resolutions adopted by the Board of Directors of SureTec Insurance Company and Markel Insurance Company: "RESOLVED, That the President, any Senior Vice President, Vice President, Assistant Vice President, Secretary, Assistant Secretary, Treasurer or Assistant Treasurer and each of them hereby is authorized to execute powers of attorney, and such authority can be executed by use of facsimile signature, which may be attested or acknowledged by any officer or attorney, of the company, qualifying the attorney or attorneys named in the given power of attorney, to execute in behalf of, and acknowledge as the act and deed of the SureTec Insurance Company and Markel Insurance Company, as the case may be, all bond undertakings and contracts of suretyship, and to affix the corporate seal thereto." IN WITNESS WHEREOF, Markel Insurance Company and SureTec Insurance Company have caused their official seal to be hereunto affixed and these presents to be signed by their duly authorized officers on the 24th day of April , 2025 . ++lHlrrrl SureTec Insurance Company ttSURAN� `t++ 4}RAAtC'r, Markel Jnance Corany i�o"• / / SEAL , By: f rP •., - 2 Y •.;c s.- r, By: ' , Michael C. Ke' g, President . q*war 'frrrr+riiu�s``+`` fliydey Jeninsrice President State of Texas County of Harris: On this 24th day of April , 2025 A. D., before me, a Notary Public of the State of Texas, in and for the County of Harris, duly commissioned and qualified, came THE ABOVE OFFICERS OF THE COMPANIES, to me personally known to be the individuals and officers described in, who executed the preceding instrument, and they acknowledged the execution of same, and being by me duly sworn, disposed and said that they are the officers of the said companies aforesaid, and that the seals affixed to the proceeding instrument are the Corporate Seals of said Companies, and the said Corporate Seals and their signatures as officers were duly affixed and subscribed to the said instrument by the authority and direction of the said companies, and that Resolutions adopted by the Board of Directors of said Companies referred to in the preceding instrument Is now in force. ti r r 11l IN TESTIMONY WHEREOF, I have hereunto set my hand, and affixed my Offirc► i"Se3Tthe day and year first above written. all By: / ___ Chelsea Turner, Notary Public E flF ,�';'� } My commission expires 7/6/2028 l3256�•' We, the undersigned Officers of SureTec Insurance Company and Markel InsRard certify that the original POWER OF ATTORNEY of which the foregoing is a full, true and correct copy is still in full force and effect and has n3rJgR r '� ��7taa a a IN WITNESS WHEREOF, we have hereunto set our hands, and affixed the Seals of said Companies, on the 5th day of May 2025 ureTec Insurance Company -o Markel Insurance Company By; By: M. Brent eaty, Assistant Secretary J ndrew Marquis, Assistant+S cretary Any Instrument issued in excess of the penalty stated above is totally void and witSlaut any validity. 4221756 For verification of the authority of this Power you may call (713)812-0800 or, any business day between 8;30 AM and 5:00 PM CST. SureTec Insurance Company IMPORTANT NOTICE Statutory Complaint Notice/ Filing of Claims To obtain information or make a complaint: You may call the Surety's toll free telephone number for information or to make a complaint or file a claim at: 1-866-732-0099. You may also write to the Surety at: SureTec Insurance Company 9500 Arboretum Blvd., Suite 400 Austin, TX 78759 You may contact the Texas Department of Insurance to obtain information on companies, coverage, rights or complaints at 1-800-252- 3439. You may write the Texas Department of Insurance at: PO Box 149104 Austin, TX 78714- 9104 Fax#: 512-490-1007 Web: http://www.tdi.state.tx.us Email: ConsumerProtection@tdi.texas.gov PREMIUM OR CLAIMS DISPUTES: Should you have a dispute concerning your premium or about a claim, you should contact the Surety first. If the dispute is not resolved, you may contact the Texas Department of Insurance. SIC TX Rider TO] Required Notices rev 072022 Page 1 of 1