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CITY SEZRIIVARYI
`fit YX
FORTWORTH
CITY OF FORT WORTH
FINAL PAYMENT REQUEST
Contract Name SKYLINE RANCH
Contract Limits
Project Type PA C1,DRAINA(3E&ST Lgcyifr
City Project Numbers 02299
DOE Number 7233
Estimate Number I Payment Number I For Period Ending 7/17=5
CD
City Secretary Contract Number 017233 Contract Time WIT)
Contract Date Days Charged to Date 169
Project Manager Long Contract is 100-00 complete
Contractor CONATSER CONSTRUCTION TAY
5327 WICHITA S"I"
FORT WORTTI, "a 76119
Inspectors LAYER / ODEN
ff
Fri ft July 17,2015 Pup I of 5
City Project Numbers 02289 DOE Number 7233
Contract Name SKYLINE RANCH Estimate Number I
Contract Limits Payment Number I
Project Type PAVING,DRAINAGE&ST LIGHT For Period Ending 7/17/2015
Project Funding
STORM DRAIN
Item Description of Items Estimated Unit Unit Cost Estimated Completed Completed
No. Quanity Total Quanity Total
I MEDIUM STONE RIPRAP 192 SY $85.00 $16,320.00 192 $16,320.00
2 24"RCP 158 LF $50.00 $7,900.00 159 $7,900.00
3 30"RCP 53 LF $67.00 $3,551.00 53 $3,551.00
4 36"RCP 63 LF $90.00 $5,670.00 63 $5,670.00
5 4'STORM JUNCTION BOX I EA $7,500.00 $7,500.00 1 $7,500.00
6 TSTORM JUNCTION BOX I EA $9,500.00 $9,500.00 1 $9,500.00
7 36"SET 1,PIPE 3 EA $4,000.00 $12,000.00 3 $12,000.00
8 10'CURB INLET I EA $2,200.00 $2,200.00 1 $2,200.00
9 15'CURB INLET 3 EA $3,500.00 $10,500.00 3 $10,500.00
Sub-Total of Previous Unit $75,141.00 $75,141.00
PAVING
Item Description of Items Estimated Unit Unit Cost Estimated Completed Completed
No. Quanity Total Quanity Total
I SWPPP>1 ACRE I LS $1,800.00 $1,800.00 1 $1,800.00
2 6"LIME TREATMENT 9960 SY $3.85 $38,346.00 9960 $38,346.00
3 HYDRATED LIME 160 TN $175.00 $28,000.00 160 $28,000.00
4 6"CONC PVMT 9400 SY $32.00 000,800.00 9400 $300,800.00
5 4"CONC SIDEWALK 4140 SF $3.00 $12,420.00 4140 $12,420.00
6 BARRIER FREE RAMP 4 EA $1,100.00 $4,400.00 4 $4,400.00
Sub-Total of Previous Unit $385,766.00 $385,766.00
STREET LIGHTS
Item Description of Items Estimated Unit Unit Cost Estimated Completed Completed
No. Quanity Total Quanity Total
I LED LIGI ITING FIXTURE 13 EA $600.00 $7,800.00 13 $7,800.00
2 RDWY ILLUM ASSMBLY 13 EA $3,600.00 $46,800.00 13 $46,800.00
3 RDWY ILLUM FOUNDATION 13 EA $1,000.00 $13,000.00 13 $13,000.00
4 6-6-6 TRIPLEX ALUM ELEC CONDUCTOR 1279 LF $5.00 $6,395.00 1279 $6,395.00
5 4"SCHEDULE 80 PVC SLEEVE 152 LF $18.00 $2,736-00 152 $2,736.00
6 6"SCHEDULE 80 PVC SLEEVE 250 LF $20.00 $5,000.00 250 $5,000.00
Friday,July 17,2015 Page 2 of 5
City Project Numbers 02299 DOE Number 7233
Contract Name SKYLINE RANCH Estimate Number I
Contract Limits Payment Number I
Project Type PAVING,DRAINAGE&ST LIGHT For Period Ending 7/17/2015
Project Funding
Sub-Total of Previous Unit $81,731.00 $91,731.00
Friday,July 17,2015 Page 3 of 5
City Project Numbers 02289 DOE Number 7233
Contract Name 5 KYLU4E RANCH Estimate Number 9
Contract Limits Payment Number I
Project Type PAVING,DRAINAGE&ST LIGM For Period Ending 7/172015
Project Funding
Contract Information Summary
Original Contract Amount $542,6380)
Change Orders
Total Contract Price $542,638.00
Date' Total Cost of or Completed $542,638.00
Less
Retained $0.00
Co E,,t
]�7 Net Earned $542,638.00
Date
jL Earned This Period $542,638M
inspection S r
Retainage This Period $0.00
Project 21 Date Less Liquidated Damages
Days @ /Day $0.00
Datt LessPavement Deficiency $0.00
A7ss if�ctorfTPW-hiftstruclum,Design and C(mritTaction Less Penalty SOM
_7 Less
ate Previous Payment $0.00
D (QL"` b
ttacting Departme t Plus Material on Hand Less 15% $0.00
Balance Due This Payment $542,639,00
Friday,July 17,2015 Page 4 of 5
City Project Numbers 02289 DOE Number 7233
Contract Name SIB n1NE RANCH Estimate Number I
Contract Limits Payment Number I
Project Type PAVING,DRAINAGE&ST LIGHT For Period Ending 7817/2015
Project Funding
Project Manager Long City Secretary Contract Number 117233
Inspectors LAYER / ODEN Contract Date
Contractor CONATSER CONSTRUCTION TXLP Contract Time 90 CD
5327 WICHITA ST Days Charged to Date 169 CD
FORT WORTH, T-X. 76119 Contract is .000000 Complete
CITY OF FORT WORTH
SUMMARY OF CHARGES
Line Fund Account Center Amount Gross Retainage Net
Funded
Total Cost of or Completed $542,638.00
Less %Retained $0.00
Net Earned $542,638.00
Earned This Period $542,638,00
Retainage This Period $0.00
Less Liquidated Damages
0 Days@ 50-00 /Day MOO
LessPavement Deficiency $0.00
Less Penalty $0.00
Less Previous Payment $0.00
Plus Material on Hand Less 15% WOO
Balance Due This Payment $542,638.00
Friday,July 17,2015 Page 5 of 5
FORTWORTH irev 0310.5107
TRANSPORTATION&PUBLIC WORKS
FINAL STATEMENT OF CONTRACT TIME
FINAL STATEMENT NO.:I
NAME OF PROJECT: aLline Ranch PhM
PROJECT NO.: 022 9 CONTRACTOR: CanatserConslaruLlion
DOE NO.: 7233
PERIOD FROM�01/26/15 TO: 07713/15 FINAL WSPFCTION'DATE: 272-,-Jul-45
WORK ORDER EFFECTIVE:1/26n'015 CONTRACT TIME:-90 0 W04 CD
DAY OF DAYS REASON FOR DAYS DAY OF DAYS REASON FOR DAYS
MONTH CHARGED CREDITED MONTH CHARGED CREDITED
DURING DURING
1. 16.
2. 17.
3. 18.
4. 19.
5. 20.
6. 21.
7. 22.
8. 23.
9. 24.
10. 25.
H. 26.
12. 27.
13. 28.
14. 29.
15. 30.
31.
SAT,SUN, RAIN,TOO WET, UTILITIES OTHERS* DAYS TOTE
& HOLIDAYS &TOO COLD RELOCATIONS CHARGED DAYS
PERIOD 169 169
PREVIOUS 0 0
PERIOD
TOTALS
O DATE 169 169
T
*REMARKS:
------------
NTRACTOR. DATE W(ECTFOR
The City of Fort Worth 1000'1"hro t• TX 76012-6311
(517)392-794
rCITY SECRETARY
114 T
Fl"m WORTH,TX
rt
tORTWORTHREV:02/20/07
II
TRANSPOWfKfION AND PUBLIC WORKS
PERFORMANCE EVALUATION OF CONTRACTOR
1) CONT RACTOR PROJECT DATA
Name ofControctor Pr4ect Natne
Conatser Construction Skyline Ranch Phase 5
Dok-i—jupector- DOE Number
W yman Oden 7233
DOE
Inspector Project Manager
IJ Water 0 Waste Water 0 Storm Drainage 0 Pavement Aaron Long
Initial Contract Antoport Proje6 Dolculty
$5424638.00 0 Simple 0 Routine 0 Complex
f7nal Contract Amount Tate
1$542,638.00 17/17/2015
H)PERFORMANCE EVALUATION
0-Inadequate I.-Deficient 2-Standard 3-Good 4-Excellent
ELEMENT WEIGIIT(x) APPLICABLE(Y/N) RATING(0-4) MAX SCORE SCORE
I Submission of Documents 2 y 4 8 8
T Public Notifications 5 N
3 Plans on Site 5 y 4 20 20
4 Field Supervision 15 y 4 60 60
T Work Performed 15 y 4 60 60
6 Finished Product 15 y 4 60 60
7 Job Site SaLet 15 7— 3 —60 45
F Traffic Control Maintenance 15 lC 4 60 60
9 Daily Clean Up 5 y 3 20 15
10 Citizen's Complaint Resolution 5 N I
J —1
II Property Restoration 5 y 4 20 20
12 After Hours Res cruse 5 N
13 Project Corn letion 5 y 3 20 15
"I'GIAL ELEMENT SCORE(A) 363
BONUS POINTS(25 Maximum)(B)
TOTAL SCORE(TS) 363
111)CONTRACTOR'S RATING
Maximum Score(MS)a-448 gr sum ofapplicable element score inaximunis whicl-ii 338
Rating(ITS1 MS]*100%) 363 1 388 94%
Performance Category 1-icellent
<20%-bradequate 20Y*1o<40%=Dqfu1en1 40%1cj,,60'li,lilll,,Fteigidtird 60%to<80%-Good 2�801/10 Excellent
Inspector's Comments(INCLUDING EXPLANATION OF BONUS POINTS AWARDED)
Signature DOE Inspector Signature Contractor
Signature DOE Inspectoes Supervisor
CONTRACTOWS COMMENTS
71RANSPO1T",EXTION AND PUBLI(".WORKS
The City offort Worth•100011u.ockmottown Street-Fort Worth,TX 7W12-6311
(81.7)392-7941 ®Fix.(817)392-7845
DE \' [ L (} PWLNT 1. TD
July }5. 2U/5
KJc O/nck |�uygina
Ci`no{uer Construct k`n '[%, LP
POBox 15448
Forl \Ynilh, 7'}( 76114
3kyHnr Ranch Cit y Case Nn. FP'8|4-N 8
[kyo[Fow Worth. State o[Texas
Dear J\/IcHu�,1ix4
SLR — BY 4, LL(`. herchy unknunleJgcy |hu( C"ou|wr [\,nx(n/cti"oTX. LP hxs conVpk]cJ 1hc
\Vu!cr and Paving pnrtin/w of the ohovc cuphoonl pn i / in x hnnciy n/unncr A||huugh the
contractual time was cxcccJcJ. SLR — BY 4� DL{` will not assess any pcnuhics or |igui'k/t,x)
dunxgcn due <o the cxicnnk`nn.
Dfyoo /xovuuuy questions, please Q| kcc to nox(ucl our office. .
Sincerely,
BcYunHoUund
�
SLR — BY4, LUC
ViceyomNwnt
-_-_ _ White _Chapel __'__- ---' -____' T' 76092 Office 21062118590 Fax 8175411455
AFFIDAVIT
STATE OF TEXAS
COUNTY OFT T
Before me, the undersigned authority, a Notary Public in the state and county aforesaid,
on this day personally appeared Brock Huggins, Vice-President of Conatser Management Group,
Inc., general partner of Conatser Construction TX LP, 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 famishing
labor andJor 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; and
That there are no claims pending for personal injury and/or property damages;
On Contract described as:
SKYLINE RANCH
WATER, SANITARY SEWER, STORM DRAIN
PAVING AND STREET LIGHT IMPROVEMENTS
DOE : 7233
CITY OF FORT WORTH
STATE OF TEXAS
CONATS CONSTR CTION TX, LP
Brock Huggins
Subscribed and swum to before me this 27'h day of
W-1 Bertha Gianulis
Nota ry Public for
Notary Pubic in Tarrant County, Texas
State of Texas
My commission expires: 919 81201 5
CONSENT OF OWNER
SURETY ANY ARCHITECT 0'
CONTRACTOR
TO FINAL PAYMENT SURETY
Conforms with the American institute or OTHER
Archftectz,AIA Document G707
Bond No 018"7842
............. ................... ......
PROJECT.
(name, address)waler and Sanitary Seger Replacement contract 2014
TO (Owner) Fbrtftrai TX
ARCHITECT'S PROJECT NO:
CTY OFOT WORTH CONTRACT FO
1000 Throckmorlon Streel ";Wne Ranch.-Water,Sanitar -AinswPavIn andStreM
I y Sewer.Or
L-It Worth TX 76102 061 flng�rnprovemenis DOE Nor,721a3,Projeci 0 0,2280
-J CONTRACT DATE.
CONTRACTOR-.CONATSER CONS1"RUCTIONTX,�-P
..................
In accordance with the provisions of the Contract between the Owner and the Contractor as indicated above, die
(hafa kisen namo and address or Swety Company)
BERKLEY INSURANCE COMPANY
475 Steamboat Road
Greenwich CT 06830 SURETY COMPANY
on bond of Mara insane name and addeass of Contractor)
CONATSER CONSTRUCTION TX,L,P.
5327 fthita St. ,
Forest HII TX 76119-6035 CONTRACTOR,
hereby approves of the final payment to the Contractor� and agrees that final pay meat to the Contractor shall not relieve
the Surety Company of any of its obligations to ihave M%en name and address of Owned
CITY OF FORT WORTH
1000,Throckmorlon Street
Fort warth '11"X 76102
OWNER,
as set forth in the said Surety Company's bond.
IN WrINESS,WI-MPLEOF,
die Suretry Company has hereunto set Ns hand this 6th day Of July,2015
EERKU EY INSURANCE COMPANY
Surety,Company
Attest: , �el
(Sea]):
Signature of Authorized Representative
Bgb I lgorgL AftoEa
.L_ _ M...........
Title
N6ii:-nNferns Is to-b-a used as a companion document to AIA DOCUMENT G7068 CONTRACTOR'S RDAViT OF PAYMENT OF DEBTS AND CLAMS,
Current Fdtinn
...........
ONE PAGE
POWER OF ATTORNEY
BERKLEY INSURANCE COMPANY
WTLMINGTON,DELAWARE
NOTICE: The warning found elsewhere in this Power of Attorney affects the validity thereof. Please review carefully.
KNOW ALL MEN BY THESE PRESENTS, that BERKLEY INSURANCE COMPANY (the "Company"), a corporation duly
organized and existing under the laws of the State of Delaware,having its principal office in Greenwich, CT,has made,constituted
and appointed, and does by these presents make, constitute and appoint: Ricardo J. Reyna; Don E. Cornell; Lisa M. Bonnof;
Vena DeLene Marshall; Sophinie Hunter; Robb! Morales; or Kelly A, Westbrook of Aon Risk Services Southwest, Inc. of
Dallas, TX.its true and lawful Attorney-in-Fact, to sign its name as surety only as delineated below and to execute, sea),
acknowledge and deliver any and all bonds and undertakings, with the exception of Financial Guaranty Insurance,providing that
no single obligation shall exceed Fifty Million and 001100 U.S. Dollars(U.S.S50,000,000,00),to the same extent as if such bonds
had been duly executed and acknowledged by the regularly elected officers of the Company at its principal office in their own
proper persons.
r; This Power of Attorney shall be construed and enforced in accordance with, and governed by, the laws of the State of Delaware,
without giving effect to the principles of conflicts of laws thereof. This Power of Attorney is granted pursuant to the following
t;, resolutions which were duly and validly adopted at a meeting of the Board of Directors of the Company held on January 25,2010:
ry
RESOLVED,that, with respect to the Surety business written by Berkley Surety Group, the Chairman of the Board, Chief
Executive Officer, President or any Vice President of the Company, in conjunction with the Secretary or any Assistant
Secretary are hereby authorized to execute powers of attorney authorizing and qualifying the attorney-in-fact named therein
to execute bonds, undertakings, recognizances, or other suretyship obligations on behalf of the Company, and to affix the
corporate sea] of the Company to powers of attorney executed pursuant hereto; and said officers may remove any such
attorney-in-fact and revoke any power of attorney previously granted;and further
RESOLVED, that such power of attorney limits the acts of those named therein to the bonds, undertakings, =Dgnimces,
or Other Suretyship obligations specifically named therein, and they have no authority to bind the Company except in the
manner and to the extent therein stated;and further
7 RESOLVED, that such power of attorney revokes all previous powers issued on behalf of the attomey-in-fact named; and
further
RESOLVED, that the signature of any authorized officer and the sea) of the Company may be affixed by facsimile to any
i
power of attorney or certification thereof authorizing the execution and delivery of any bond, undertaking,, recognizance, or
other suretyship obligation of the Company;and such signature and sea) when so used shall have the same force and effect as
though manually affixed, The Company may continue to use for the purposes herein stated the facsimile signature of any
CL
person or persons who shall have been such officer or officers of the Company, notwithstanding the fact that they may have
ceased to be such at the time when such instruments shall be issued.
IN WITNESS WHEREOF, the Corppany has -,d thm presents to be signed and attested by its appropriate officers and its
corporate sea] hereunto affixed this�day of "t_ 2015.
Attest: Berkley Insurance Company
(Seat) By
V S.' ederm 4eHpafte,
Senior Vice President&Secretary President
WARNING:T-41S POWER INVALID IF NOT PRINTED ON BLUE"BERKLEY"SECURITY PAPER.
STATE OF CONNECTICUT)
ss.,
X, COUNTY.OF FAIRFIELD
Sworn to before me,allotary Public in the State of Connecticut, this day of Eck 2015, by Ira S. Lederman and
—
Jeffrey M.Hafter Who are SWOM to me to be the Senior Vice President and Secretary.., and the Senior Vice P esident,respectively,of
Berkley Insurance Company,
MARIA C.RUNDBAKEN
NOTARY PUBLIC
My COMMISSION EXPIRES
Notary Public,State of Connecticut
APRIL 30,2019
CERTIFICATE
1,the undersigned,Assistant Secretary of BE LEY INSURANCE COMPANY,DO HEREBY CERTIFY that the foregoing is a
true, correct and complete copy of the original Power of Attorney; that said Power of Attorney has not been revoked or rescinded
and that the authority of the Attorney-in-Fact set forth therein, who executed the bond or undertaking to which this Power of
Attomey is attached, is in full force and effect as of this date.
Given under my hand and seal of the Company,this 6th day of Jul v 2015 .
(Seal)
Andr�E w
FORTi H RE.Vz 02/22/07
TRANSPORTATION AND PUBLIC WORKS
CONTRACTOR'S EVALUATION OF CITY
1)PROJECT INFORMATION Date:
fff7—20
Nam of Contractcpr
P
Conatser Consti-riction Skyline Ranch Phase 5
Prqjecl Alanager
Weyman Oden Aaron Long
ME_N11;,16—er " ProjectDWwulty T)Ve of Cono-act
7233 0 Simple Routine 0 Camplex 0 Water 0 Waste Water 0, Storm m.....a_ry 3 Pavement
Initial(,oniract Amount Final Contrace Amato
$542,638.00 $542,63&00
..........
II)PERFORMANCE EVALUATION
0-Inadequate I -Deficient 2-Standard 3-Good 4-Excellent
�ATINCY-
ELEMENT flkATING ELEMENT
(0
(0-4) (0-4)
PLANS&SPECIFICATIONS
INSPECTION EVALUATION
I Availability of Inspector I Accuracy of Plans to Existing Conditions
2 Knowledge of Inspector 11 2 Clarity&Sufficiency of Details
3 Accuracy of Measured Quantities 3 AAp icabilityof',Specifications
............
4 Display Of Professionalism Accuracy of Plan Quantities
5 Citizen Complaint Resolution PROJECT MANAGER EVALUATION
e-Baffin `up'-�1�'alve Cremes,T��S I Knowledge.And/Or Problern Resolution 7-7T
T, Pe;To aTc"'
ADMINISTRATION 2 Availability of Project Manager
I Change Order Processing Tune T,—Communic—ation.................
2_Timiliness of Contractor a -nents �fionofUifii Conflicts
..........
3 .2�tdOpe±i2�to Pre-Con!�eeting'Tftneframe 1,�
............
III)COMMENTS&SIGNATURES
COMMENTS
......................
Signature Contractor
Signature DOE Inspector
Signature DOE Inspector's Supervisor
INSPECTOR'S COMMENTS
.......... ...... .........
'ERA.NSP0WfA'l10N AND PUBLIC WORKS
..........m.....:
'Inle(Ch aof Fort Worth•1000 11%rocluvorton Street•Fort Worth,IX 76012 6311
(817 392-7941 •Fax.(817)392 7845