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City Project Numbers 00369
DOE Number 6898
Contract Name East Side II 54-Lich Water Main-Phase 3 Estimate Number 40
Contract Limits from Scott Ave to Vickery Blvd oh Payment Number 40
Project T e Sewer Relocation
yF ) r � For Period Ending 9/17P2015
J
Project Funding
Project Manager Schwinger City Secretary Contract Number 43993
Inspectors Johnson / Brice Contract Date 11/12/2012
Contractor S.J.LOUIS CONSTRUCTION OF TEXAS,LTD Contract Time 538 CD
P.O.BOX 834 Days Charged to Date 538 CD
MANSFIELD, TX 76063-0834 Contract is .000000 Complete
CITY OF FORT WORTH` 51�
SUMMARY OF CHARGE "1VOICE #
Line Fund Account Center Amount Gross Retainage Net
_ _ _ __Funded
� �
A
Total Cost of Work Completed $4907,059.47
Less 0 %Retained $0.00
Net Earned $4,907,059.47
. A f'ER DEPAKTMENT Earned This Period $107,941.80
ENGINEERING AND FISCAL SERVICES
Retainage This Period $0.00
C�nws 0 Ext.849
Sig t Less Liquidated Damages
0 Days @ $0.00 /Da D y $0.00
A,RTMENTCHECI NC UP A �� LessPavement Deficiency $0.00
Less Penalty $0.00
Less Previous Payment $4,799,117.67
Pius Material on Hand Less 15% $0.00
Balance Due This Payment $107,941.80
Thursday,September 17,2015 Page 6 of 6
FORTWAII-1
CITY OF FORT WORTH
FINAL PAYMENT REQUEST
Contract Name East Side It 54-Inch Water Main-Phase 3
Contract Limits from Scott Ave to Vickery Blvd
Project Type Water Relocation
City Project Numbers 00369
DOE, Number 6898
Estimate Number 40 Payment Number 40 For Period Ending 9/1712015
CD
City Secretary Contract Number 43993 Contract Time 53ED
Contract Date 11/12/2012 Days Charged to Date 538
Project Manager Schwinger Contract is 98-000 Complete
Contractor S.J.LOUIS CONSTRUCTION OF TEXAS,LTD
P.O.BOX 834
MANSFIELD, TX 76063-0834
Inspectors Johnson Brice
II
Thursday,September 17,2015
Page I of 6
City Project Numbers 00369 DOE Number 6898
Contract Name East Side 1154-Inch Water Main-Phase 3 Estimate Number 40
Contract Limits from Scott Ave to Vickery Blvd Payment Number 40
Project Type Water Relocation For Period Ending 9/17/2015
Project Funding
Section A-Water
Item Description of Items Estimated Unit Unit Cost Estimated Completed Completed
No. Quanity Total Quanity Total
la 3311.1174 54"Concrete AWWA C303 Wa 5260 LF $380.00 ,998,800.00 5188 1,971,440.00
lb 3311.1161 54"Polyurethane Coated S 5260 LF $0.00 $0.00
le 3311.1152 54"DIP Water(Pressure C 5260 LF $0.00 $0.00
2a 3305.2012 54"Water Carrier Pipe AW 1200 LF $406.00 £487,200.00 1217 $494,102.00
2b 3305.2012 54"Polyurethane Coated S 1200 LF $0.00 $0.00
2e 3305.20I2 54"Water Carrier Pipe Du 1200 LF $0.00 $0.00
3a 3311.0021 54"Bar Wrapped Concrete 1 LS $L00 $1.00 1 $1.00
3b 3311.001154"Polyurethane Coated St i LS $0.00 $0.00
3c 3311.000154"Ductile Iron Water Fit 77.89 TO $0.00 $0.00
4a 3304.0002 Cathodic Protection Syste 1 LS $2,000.00 $2,000.00 1 $2,000.00
4b 3304.0002 Cathodic Protection Syste I LS $0.00 $0.00
4c 3304.0002 Cathodic Protection Syste I LS $0.00 $0.00
5 3311.0241 8"Water Pipe 2550 LF $48.00 £122,400.00 2246.5 $107,832.00
6 3311.0141 6"Water Pipe 100 LF $38.00 $3,800.00 106 $4,028.00
7 3305.1207 78"Casing/Tunnel Liner 1210 LF $1,200.00 ,452,000.00 1217 I,460,400.00
8 3312.5003 54"AWWA Butterfly Valve, 3 EA $77,600.00 $232,800.00 3 $232,800.00
9 3312.3003 8"Gate Valve 22 EA $1,100.00 $24,200.00 14 $15,400.00
10 3312.3002 6"Gate Valve 6 EA $700.00 $4,200.00 8 $5,600.00
11 3312.1006 8"Combination Air Valve 4 EA $17,500.00 $70,000.00 4 $70,000.00
12 3312.6004 12"Blow Off Valve&Van] 4 EA $15,800.00 $63,200.00 4 $63,200.00
13 3312.0001 Fire Hydrant 5 EA $3,500.00 $17,500.00 5 $17,500.00
14 3312.2003 V Water Service 7 FA $1,500.00 $10,500.00 9 $13,500.00
15 3312.2203 2"Water Service 1 EA $2,500.00 $2,500.00 1 $2,500.00
16 3304.0101 Temporary Water Services 1 LS $1.00 $1.00
17 3216.0101 6"Cone Curb and Gutter 600 LF $16.00 $9,600.00 1167.5 $18,680.00
18 3213.0402 7"Concrete Driveway and 50 SY $50.00 $2,500.00 164.12 $8,206.00
19 3201.0117 10'Wide(Permanent)Aspha 1900 LF $63.00 $119,700.00 1248.74 $78,670.62
20 3201.0124 T Wide(Permanent)Aspha(CO#2) 50 LF $44.00 $2,200.00 308.64 $13,580.16
21 3201.0114 T Wide(Permanent)Aspha 200 SY $43.00 $8,600.00
22 3201.0203 Asphalt Pvmt Repair Beyon(CO#2) 341 SY $57.00 $19,437.00 457.73 $26,090.61
23 3201.0400 Temporary Asphalt Paving 4600 LF $0.01 $46.00 4313 $43.13
Thursday,September 17,2015 Page 2 of 6
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City Project Numbers 00369 DOE Number 6898
Contract Name East Side H 54-Inch Water Main-Phase 3 Estimate Number 40
i
Contract Limits from Scott Ave to Vickery Blvd Payment Number 40
Project Type Water Relocation For Period Ending 9117/2015
Project Funding
24 3216.0302 7"Conc Valley Gutter 60 SY $50.00 $3,000.00 49.52 $2,476.00
25 3211.0323 8"Flex Base,Type D,GR- 100 SY $7.00 $700.00 1613 $11,291.00
26 3292.0400 Seeding,Hydromulch 8000 SY $010 $1,600.00 8000 $1,600.00
27 Golf Course Restoration by"Golf Con 7000 SY $3.50 $24,500.00 6956 $24,346.00
28 3292.0100 Block Sod Placement 1680 SY $2.50 $4,200.00
29 3305.0103 Exploratory Excavation of 23 EA $500.00 $11,500.00 23 $11,500.00
30 3305.0109 Trench Safety 8400 LF $0.01 $84.00 8400 $84.00
31 3311.0001 Ductile Iron Water Fittin 2.11 TO $1.00 $2.11 2.11 $2.11
32 3125.0101 SWPPP>1 Acre I LS $14,000.00 $14,000.00 1 $14,000.00
33 0330.0001 Flowable Fill Encase Pipe(CO#2) 450 CY $65.00 $29,250.00 623 $40,495.00
34 0241.1355 Remove 6"Water Valve 10 EA $100.00 $1,000.00 10 $1,000.00
35 0241.1510 Salvage Fire Hydrant 4 EA $100.00 $400.00 4 $400.00
36 3471.0001 Traffic Control 1 LS $1.00 $1.00 1 $1.00
37 3305.0203 Imported Backfill,CLSM( 200 CY $65.00 $13,000.00
38 3305.0204 Imported Embedment/Backfi 50 CY $23.00 $1,150.00
39 3305.0207 Imported Embedment/Backfi 50 CY $10.00 $500.00
40 Water Main Access Manhole 1 EA $7,300.00 $7,300.00 1 $7,300.00
41 3312.0101 Connection to Existing 4" 3 EA $1.00 $3.00 3 $3.00
42 3312.0102 Connection to Existing 6" 6 EA $1.00 $6.00 6 $6.00
43 3312.0103 Connection to Existing 8" 5 EA $1.00 $5.00 4 $4.00
44 3312.0113 Connection to Existing 54 2 EA $1.00 $2.00 2 $2.00
45 3231.0113 New 8'Chain Fence 1200 LF $17.00 $20,400.00 217 $3,689.00
46 3231.0114 Temporary 8'Chain Link,S 1200 LF $2.00 $2,400.00 1200 $2,400.00
47 Temporary Irrigation Sprinkler Heads(CO#2) 21 EA $500.00 $10,500.00 21 $10,500.00
48 Irrigation System Repair at Sycamore 1 LS $5,000.00 $5,000.00 1 $5,000.00
49 Restoration of Sycamore Golf Course 1 LS $5,000.00 $5,000.00 1 $5,000.00
50 Topsoil from Silver Creek for Sycamore Golf 1872 CY $34.29 $64,190.88 1872 $64,190.88
Course(CO#1)
G
51 New Chainlink Fence at the S end of PACS(CO#2) 1 LS $4,453.00 $4,453.00 1 $4,453.00
52 30 Gallon Holly Bushes-Sycamore Cr GC(C092) 11 EA $517.49 $5,692.39 11 $5,692.39
53 Install Concrete Curb stop at chaninlink fence 30 LF $20.00 $600.00 30 $600.00
(CO#2)
54 30"RCP between two inlets Sta 29+80 on 2 EA $3,000.00 $6,000.00 2 $6,000.00
Camilla(CO#2)
55 Wadsworth Shutdown cost to enable CFW design of 1 LS $1,308.70 $1,308.70 1 $1,308.70
Valkus(C0#2)
Thursday,September 17,2015 Page 3 of 6
City Project Numbers 00369 DOE Number 6898
Contract Name East Side 11 54-Inch Water Main-Phase 3 Estimate Number 40
Contract Limits from Scott Ave to Vickery Blvd Payment Number 40
Project Type Water Relocation For Period Ending 9/17J2015
Project Funding
-------------------------------------------
Sub-Total of Previous Unit $4,890,933.08 $4,828,917.60
Section B-Sewer
Item Description of Items Estimated Unit Unit Cost Estimated Completed Completed
No. Quanity Total Quanity Total
---------------------------------------
1 3331.4115 8"Sewer Pipe(CO#2) 798 LF $33.00 $26,334.00 775 $25,575.00
2 3331,4201 10"Sewer Pipe 170 LF $36.00 $6,120.00 162 $5,832.00
3 3339.1001 4'Manhole(CO#2) 3 EA $2,800.00 $8,400.00 3 $8,400,00
4 3339.1003 V Extra Depth Manhole(C0#2) I1 VF $100.00 $1,100.00 7.2 $720.00
5 3339.1002 4'Manhole Drop Manhole I EA $4,000.00 $4,000.00 1 $4,000.00
6 3339,1004 4'Manhole Shallow Manhol(CO#2) 3 EA $2,500.00 $7,500.00 3 $7,500.00
7 3301-0101 Manhole Vacuum Testing(CO#2) 6 EA $100.00 $600.00 6 $600.00
8 3305.0112 Concrete Collar(CO#2) 6 EA $400.00 $2,400.00 3 $1,200.00
9 3331.3101 4"Sewer Service(CO#2) 10 EA $1,500.00 $15,000.00 8 $12,000.00
10 0241.2201 Remove 4'Sewer Manhole(CO#2) 6 EA $700.00 $4,200.00 5 $3,500.00
11 3305.0109 Trench Safety(C0#2) 968 LF $0.01 $9.68 937 $9.37
12 3216.0302 7"Cone Valley Gutter 100 SY $50.00 $5,000.00 25.93 $1,296.50
13 3216.0101 6"Cone Curb and Gutter 170 LF $16.00 $2,720.00
14 3201-0114 7'Wide Asphalt Pvmt Repa 20 LF $33.00 $660.00
15 3201.0124 TWide Asphalt Pvmt Repa(C092) 188 LF $44.00 $8,272.00 108 $4,752.00
16 3201.0203 Asphalt Pvmt Repair Beyon(CO#2) 0 SY $44.00 $0.00
17 3201.04 Temporary Asphalt Paving Re 640 LF $0.01 $6.40 250 $2.50
18 3292.0400 Seeding,Hydromulch 200 SY $0.20 $40.00 200 $40.00
19 3292.0100 Block Sod Placement 150 SY $2.50 $375,00
20 3301.0001 Pre-CCTV Inspection 860 LF $100 $1,720.00 850.5 $1,701.00
21 3301.0002 Post-CCTV Inspection(CO#2) 908 LF $1.00 $908.00 1013.5 $1,013.50
------------------------------------------
Sub-Total of Previous Unit $95,365.08✓ $78,141.87
--------------------------------------
Thursday,September 17,2015 Page 4 of 6
City Project Numbers 00369 DOE Number 6898
Contract Name East Side 1154-Inch Water Main-Phase 3 Estimate Number 40
Contract Limits from Scott Ave to Vickery Blvd Payment Number 40
Project Type Sewer Relocation For Period Ending 9117/2015
Project Funding
Contract Information Summary
Original Contract Amount $4,920,941.11
Change Orders
Change Order Number 1 $64,190.88
Change Order Number 2 ($10,558.91)
Change Order Number 2 $11,725.08
Change Order Number 3 $0.00
Change Order Number 3 $0.00
Total Contract Price $4,986,298.16
Date S4,907,059-47
Total Cost of Work Completed
Contr ctor Less 0 %Retained $0.00
Date
Net Earned $4,907,059.47
Inspection Supervisor Earned This Period $107,941.80
Retaivage This Period $0.00
Less Liquidated Damages
Project Manager
Days @ Day $0.00
Date LessPavement Deficiency $0.00
Asst.I ��,aarr sign and tructio
n Less Penalty $0.00
7
Date le
Co,2 Less Previous Payment $4,799,117.67
41-Director 1 Contracting Depaxtn� 7--7 Plus Material on Hand Less 15% $0.00
Balance Due This Payment $107,941.80
Thursday,September 17,2015
Page 5 of 6
rev 03/05/07
FORTWORTH
WATER ENGINEERING&FISCAL SERVICES
FINAL STATEMENT OF CONTRACT TIME
FINAL STATEMENT NO.:40
NAME OF PROJECT: East Side 1154"Water Main Phase 3
PROJECT NO.: Water:P265-6081400369,P262-6081400369 CONTRACTOR: S.J.Louis Consrtuction
Sewer:P275-7081400369 DOE NO.: 6898
PERIOD FROM:11/12/12 TO: 09/17/15 FINAL INSPECTION DATE: 8/11/2014
WORK ORDER EFFECTIVE:1/8/2013 CONTRACT TIME: 538 0 WT* CD
DAY OF DAYS REASON FOR DAYS DAY OF DAYS REASON FOR DAYS
CHARGED
CHARGED
MONTH CREDITED MONTH CREDITED
DURING DURING
1. x 16. x
2. x 17. x
3. x 18. x
4. x 19. x
S. x 20. x
6. x 21. x
7. x 22. x
8. x 23. x
9. x 24. x
10. x 25. x
11. x 26. x
12. x 27. x
13. x 28. x
14. x 29. x
15. x 30. x
31. x
-SAT,SUN, RAIN,TOO WET, UTILITIES OTHERS DAYS TOTAL
*
&HOLIDAYS &TOO COLD RELOCATIONS CHARGED DAYS
THIS
PERIOD 0 0
PREVIOUS
PERIOD 538 53
TOTALS
5
TO DATE 38 538
*REMARKS:
LLI-71�'
CONTRACtOR DATE INSPECTOR DATE
WATER ENGINEERING&FISCAL SERVICES
The City of Fort Worth-1000 Throckmorton Street-Fort Worth,TX 76012-6311
(L)F F,"�C I'A I'll, R
(817)392-4477-I=(817)392-8460
Mlf SEC111"ll"A-e'R"'l('V?"
f"T I)
?,V0!'?tTH, "TX
FoRTWORTH
WATER ENGINEERING&FISCAL SERVICES
PIPE REPORT FOR:
PROJECT NAME: East Side H 54-Inch Water Main Phase 3
PROJECT NUMBER: Water P265-6081400369,P262-6081400369;Sewer P275-7081400369
DOE NUMBER: 6898
WATER
PIPE LAID SIZE TYPE OF PIPE LF
WATER 54" Concrete C-303 6405
WATER 811 Poly Vinyl Chloride(PVC) 2246.5
WATER 6" PVC 106
FIRE HYDRANTS: 5 VALVES(1611 OR LARGER) 3
PIPE ABANDONED SIZE TYPE OF PIPE LF
Water 811 PVC 2246.5
Water 6" PVC 106
DENSITIES: 38
NEW SERVICES:
SEWER
PIPE LAID SIZE TYPE OF PIPE LF
SEWER 811 PVC 775
SEWER lotl PVC 162
PIPE ABANDONED SIZE TYPE OF PIPE LF
SEWER 611 Concrete 775
SEWER 611 Vitrified Clay Pipe(VCP) 162
DENSITIES: 5
NEW SERVICES:
WATER ENGINEERING&FISCAL SERVICES
The City of Fort Worth-1000 Throclunorton Street•Fort Worth,TX 76012-6311
(817)392-4477•Fax:(817)392-8460
City of Fart Worth
Change Order Request
Project Namel East Side II 54-Inch Water Main-Phase 3 City Sec No. F43993
Project No.(s) P262-608140036987 and P265 608140036987 DOE No. 6898 City Proj.No.1 00369
Project Description: 54-Inch Water Main Installation from Scott Avenue to Vickery Boulevard.
Contractor:I S.J.Louis Construction of Texas,Ltd Change Order: F3 1 Date: 9/15!2015
City Project Mgr.1 Susan Schwinger City Inspector: Raymond Brice
Phone Number: 817-392-6529 Phone Number: 817-392-8452
Dept. Water Sewer Totals Contract Time
(Calender days)
Original Contract Amount $4,837,301.11 $83,640.00 $4,920,941,11 210
Extras to Date $64,190.88 $11,725.08 $75,915.96 5
Credits to Date $10,558.91 $10,558.91
Pending Change Orders(in M&C Process)
Contract Cost to Date $4,890,933.08 $95,365,08 $4,986,298.16 215
Amount of Proposed Change Order $0.00 $0.00 323
Revised Contract Amount $4,890,933,08 $95,365.08 $4,986,298.16 538
Original Funds Available for Change Orders $295,500.00 $0.00 $295,500.00
Remaining Funds Available for this CO $241,868.03 $0.00 $241,868,03
Additional Funding(if necessary)
CHANGE ORDERS to DATE(INCLUDING THIS ONE)AS%OF ORIGINAL CONTRACT 1 1.33%
MAXALLOWABLE CONTRACT AMOUNT(ORIGINAL CONTRACT COST+25%) $6,151,176.39
Staff recommends the approval of an additaional 323 calendar days for the following delays on the
project:
Complying with all Parl<and Community Services Department's requirements before construction on
Sycamore Golf Course.
Easement negotiations with adjacent property owners.
,3,w
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• City Secretmy
00 '
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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.
,, ,,,.. EVEN ii,i�
C6 a kor„sCompartY, timer, /i, , ;Cottfrdojuf%japle ,;/ f
S.J. ouis onstruction Texas,Ltd Pete Stahl I .w
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n 09/71
sslstant,l��.
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M&C Number NIA M&C Date Approved N/A
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F4DP,-r Oa'Fm City of Fort Worth
Change Order Additions
is
Project Name I East Side II 54-Inch Water Main-Phase 3 City Sec No, 43993
Project No.(s) P262 6Q8140036987 and P265-608140036987 DOE No. 6898 City Proj.No. 369
Project 54-Inch Water Main Installation from Scott Avenue to Vickery Boulevard. t
Description r
Contractor S.J.Louis Construction of Texas,Ltd Change Order: Date: 9!15/2015
City Project Mgr. Susan Schwinger City Inspector E Raymond Brice
i
ADDITIONS
— [115 V —
9
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Water
Sewer t
t
Page 2 of 4 t
Additions Sub Total � ',
Fc">n-.r Wo na,vi City of Fort Worth
Change Order Deletions
Project Name East Side II 54 Inch Water Main-Phase 3 City Sec No.
Project No.(s) P262-608140036987 and P265-608140036987 DOE No. 6898 City Proj,No.
Project Description 54-Inch Water Main Installation from Scott Avenue to Vickery Boulevard,
Contractor S,J.Louis Construction of Texas,Ltd Change Order: F-3 Date 9/15/2015
City Project Mgr. Susan Schwinger City Inspector I Raymond Brice
DELETIONS
ITEM DESCRIPTION DEPT City Unit Unit Cost Total
.............
Water
Sewer
Page 3 of 4 Delelions Sub Total
3
S � '
3 '
MIWBE Breakdown for this Change Order
3 I,
3
TotalY
}
Previous Change Orders i
i
Total
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Page 4 of 4
FORT WORTH CONTRACTOR'S AFFIDAWT OF
PAYMENT OF DEBTS AND CLAIMS
V
City of Fort Worth,TX
PROJECT: EAST SIDE 1154"WATER MAIN PHASE III PROJECT NUMBER:
OWNER: _City of Fort Worth TX 00369
CONTRACTO S1 Louis Construction of Texas,Ltd. 21236-10
ENGINEER: Freese and Nichols,Inc N/A
The Contractor,in accordance with the Contract Documents,hereby certifies that, except as listed below,all
obligations for all materials and equipment furnished,for all work labor, and services performed, and for all known
indebtedness and claims against the Contractor for damages arising in any manner in connection with the
performance of the Contract referenced above for which the Owner or his property might in any way be held
responsible have been paid in full or have otherwise been satisfied in full.
EXCEPTIONS: (If none,write"(NONE". The Contractor shall furnish a bond,acceptable to the Owner,
for each exception.)
NONE
CONTRACTOR S.J. Louis Construction of Texas, Ltd.
ELIZABUH ANN IN N1
A..
f,ry
Public,Sta-1 of xaS
M commission Expires
BY Les V. Whitman
nay 10, 7 P)
TITLE General Manager
Subscribed and sworn to before me this 10th day of September , 2015
Notary Public: � (
— U)— �,�LL
My Commission Expires: May 10, 2017
FORTWORTH
CONTRACTOR'S AFFIDAVIT
OF RELEASE OF LIENS
The City of Fort Worth
PROJECT: AST SIDE 1154"WATER MAIN PHASE III PROJECT NUMBER:
_dW_NE R. ity of Fort Worth TX 00369
CONTRAGA"TOR: J.Louis Construction of Texas,Ltd. 21236-10
ENGINEER: reese and Nichols,Inc
The Contractor,in accordance with the Contract Documents,and in consideration for the full and final payment to
the Contractor for all services in connection with the project,does hereby waive and release any and all liens,or
any and all claims to liens which the Contractor may have on or affecting the project as a result of its contract(s)
for the Project or for performing labor and/or furnishing materials in any way connected with the construction of
any aspect of the project. The Contractor further certifies and warrants that all subcontractors of labor and/or
materials for the Project, except as listed below, have been paid in full for all labor and/or materials supplied to, for,
through or at the direct or indirect request of the Contractor prior to, through and including the date of this affidavit.
EXCEPTIONS: (If none,write"NONE". The Contractor shall furnish a bond,acceptable to the Owner,for
each exception.)
NONE
1111GPAN1
Y
CONTRACTOR S.J. Louis Construction of Texas, Ltd.
/
bl 10, 2017
y
Les V.Whitman
vi
B /7",, M�
Title General Manager
Subscribed and sworn to before me this 10th —day of September _, 2015
Notary Public:
My Commission Expires: May 10.2017
1
Bond Number: 190016703
ISSUED IN THREE(3)COUNTERPARTS
consENr o SURETY Y COMPANY ORTH FINAL P EN
City of Fort Worth,TX
PROJECT: EAST SIDE 11 54"WATER MAIN PHASE III PROJECT NUMBER:
OWNER: _CitV of Fort Worth TX 00369
CONTRACTOR: S.J.Louis Construction of Texas,Ltd. 21236-10 j
ENGINEER: Freese and Nichols, Inc
i
The Surety Company,on bond of the Contractor listed above for the referenced project, in accordance with the
Contract Documents,hereby approves final payment to the Contractor,and agrees that final payment to the
Contractor shall not relieve the Surety Company of any of its obligations to the Owner under the terms of the
Contract and as set forth in said Surety Company's bond.
In witness whereof,the Surety Company has hereunto set its hand this 10th day of September 2015
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Liberty Mutual Insurance Company
Surety Company
By
uthorized Representative
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Title v. DeLene Marshall,Attorney-In-Fact _
Address:
175 Berkeley Street Boston, MA 02116
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Attach Power of Attorney
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THIS POWER OF ATTORNEY IS NOT VALID UNLESS IT IS PRINTED ON RED BACKGROUND.
This Power of Attorney limits the acts of those named herein,and they have no authority to bind the Company except in the manner and to the extent herein stated.
Certilicate,No.6901256
American Fire and Casualty Company Liberty Mutual Insurance Company
The Ohio Casualty Insurance Company WestAmerican Insurance Company
POWER OF ATTORNEY
KNOWN ALL PERSONS BY THESE PRESENTS:That American Fire&Casualty Company and The Ohio Casualty Insurance Company are corporations duly organized Linder the laws of
the State of New Hampshire,that Liberty Mutual Insurance Company is a corporation duly organized under the laws of the State of Massachusetts,and West American Insurance Company
is a corporation duly organized under the laws of the State of Indiana(herein collectively Galled the'Companies),pursuant to and by authority herein set forth,does hereby name,constitute
and appoint, Don E,Cornell;Kelly A.Westbrook;Lisa M.Bonnot;Ricardo J.Fleyna;Robbi Morales;Sophinie Hunter;V.DeLene Marshall
all of the city of Dallas state of TX each individually if there be more than one named,its true and lawful attorney-in-fact to make,execute,seal,acknowledge
and deliver,for and on its behalf as surely and as its act and deed,any and all undertakings,bonds,recognizances and other surely obligations,in pursuance of these presents and shall
be as binding upon the Companies as if they have been duly signed by the president and attested by the secretary of the Companies in their own proper persons.
IN WITNESS WHEREOF,this Power of Attorney has been subscribed by an authorized officer or official of the Companies and the corporate seals of the Companies have been affixed
thereto this loth day of March 2015
No IINS,1& American Fire and Casualty Company
The Ohio Casualty Insurance Company U)
1906 E 0 1919 1912 1991 s:
Liberty Mutual Insurance Company
W .5
West merican Insurance Company
10 C
Or By:
STATE OF PENNSYLVANIA ss David M.CareKAasistant secretary C:
COUNTY OF MONTGOMERY
0
tM On this loth dayof March 2015.before me personally appeared David M.Carey,who acknowledged himself to be the Assistant Secretary of American Fire an d M
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a) Casualty Company,Liberty Mutual Insurance Company,The Ohio Casualty Insurance Company,and WestAmerican Insurance Company,and that he,as such,being authorized so to do, >,LUL),
:3
0 execute the foregoing instrument for the purposes therein contained by signing on behalf of the corporations by himself as a duly authorized officer. a)
E E
IN WITNESS WHEREOF,I have hereunto subscribed my name and affixed my notarial seal at Plymouth Meeting,Pennsylvania,on the day and year first above written. CL
Six Pft� COMMONWEALTH OF PENNSYLVANIA 90
4t 4:t
Notarial Seal 4-In
M Teresa Postella,Notary Public By:
Plymouth Up.,Montgomery County 1.
y Teresa Pastella,Notary Public 0)
My Commission Expires
101- o 117 March 28,
60 Member,Pennsylvania Association of Notaries
ba 0 E
0 CL M
r- m This Power of Attorney is made and executed pursuant to and by authority of the following By-laws and Authorizations of American Fire and Casualty Company,The Ohio Casualty Insurance to C)
6 Company,Liberty Mutual Insurance Company,and WestAmerican Insurance Company which resolutions are now in full force and effect reading as follows: Q
CIO
M (D ARTICLE IV-OFFICERS-Section 12.Power of Attorney.Any officer or other official of the Corporation authorized for that purpose in writing by the Chairman or the President,and subject 0 r-
to such limitation as the Chairman or the President may prescribe,shall appoint such aftomeys-in-fact,as may be necessary to act in behalf of the Corporation to make,execute,seal,
O acknowledge and deliver as surety any and all undertaldings,bonds,recognizances and other surety obligations.Such aftomeys-in-fact,subject to the limitations setforth in their respective
E 6 powers of attorney,shall have full power to bind the Corporation by their signature and execution of any such instruments and to attach thereto the seal of the Corporation. When so %D
'10 executed,such instruments shall be as binding as If signed by the President and attested to by the Secretary.Any power or authority granted to any representative or aftomey-In-fact under >
the provisions of this article may be revoked at any time by the Board,the Chairman,the President or by the officer or officers granting such power or authority. Q)
g =
ARTICLE XIII-Execution of Contracts-SECTION 5.Surety Bonds and Undertakings.Any officer of the Company authorized for that purpose in writing by the chairman or the president, eQ
eq
-in-fact,as may necessary to in behalf of the Company to make,execute, h:ce)
> and subject to such limitations as the chairman or the president may prescribe,shall appoint such allomeys E
seal,acknowledge and deliver as surety any and all undertakings,bonds,recognizances and other surety obligations. Such attorneys-in-fact subject to the limitations set forth in their
Z 0 respective powers of attorney,shall have full power to bind the Company by their signature and execution of any such instruments and to attach thereto the seal of the Company.When so 00
executed such Instruments shall be as binding as if signed by the president and attested by the secretary.
Certificate of Designation-The President of the Company,acting pursuant to the Bylaws of the Company,authorizes David M.Carey,Assistant Secretary to appoint such aftomeys.in-
fact as may be necessary to act on behalf of the Company to make,execute,seal,acknowledge and deliver as surety any and all undertakings,bonds,recognizances and other surety
obligations.
Authorization-By unanimous consent of the Company's Board of Directors,the Company consents that facsimile or mechanically reproduced signature of any assistant secretary of the
Company,wherever appearing upon a certified copy of any power of allomey issued by the Company in connection with surely bonds,shall be valid and binding upon the Company with
the same force and effect as though manually affixed.
1,Gregory W.Davenport,the undersigned,Assistant Secretary,of American Fire and Casualty Company,The Ohio Casualty Insurance Company,Liberty Mutual Insurance Company,and
West American Insurance Company do hereby certify that the original power of attorney of which the foregoing is a full,true and correct copy of the Power of Attorney executed by said
Companies,is in full force and effect and has not been revoked.
IN TESTIMONY WHEREOF,I have hereunto set my hand and affixed the seals of said Companies this Acnay Of 9"NQr1`4V-Y--% 20 .
FPN0CASVy All INS& 4lti5Up %INSUIP,
1906 np O 1919
1912 1991 By:
C Gregory W.Davenport,Assistant Secretary
403 of 500
LMS12873_122013
FORTWOR"M REV:02/22/07
WATER ENGINEERING AND FISCAL SERVICES
CONTRACTOR'S EVALUATION OF CITY
TJ PROJECT INFORMATION Date:fo-& ,5--
Name of Contractor Project Name
S.J.Louis Construction of Texas Ltd. East Side 11 54-inch Water Main Phase 3
Water Engineering Inspecto"r ....... Project Manager
Raymond Brice Sus4u§chwipger,P.E.
Project DOE Number Type of Contract
6898 0 Simple 0 Routine @) complex E] Water Waste Water StormDrainagEE] Pavement
Kiii_aiContra'ct Amount Final Contract Amount
$4,920,941.11 $4,986,298.16
H)PERFORMANCE EVALUATION
4-Excellent
equate__ I -Deficient 2-Standard 3-Good
ELEMENT fiNG ELEMENT JaTJNG
(0-4) (0-4)
INSPECTION EVALUATION PLANS&SPECIFICATIONS———
Availability--o-f—,I,-n,sp-e,-c,-t-o-r—------ Accuracy of Plans to Existing Conditions�pm 2 Knowledge of Inspector _ __ _ 2 C!FLty&Sufficiency of Details�
3 Accuracy of Measured Quantities 3 Applicability of Specifications.
4 Dis la Of Y t—Y
Professionalism Accuracy of Plan Quantities
5 Citizen Complaint Resolution PROJECT MANAGER EVALUATION
6 Performance-Setting up t.�oi�le e And/Or Problem Resolution'--
__I _IgL
ADMINISTRATION 2 Availability------ y ojectManager
I Change Order Processing Time 3 Communication
4 Resolution of Utility Conflicts
3 Bid Opening t Pre-Con Meeting Timeframe
III)COMMENTS&SIGNATURES
COMMENTS
Signature Contractor
Signature Inspector
Signature Inspector's Supervisor
INSPECTOR'S COMMENTS
Water En eerin&,and Fiscal Services
The City of Fort Worth•1000 Throckmorton Street-Fort Worth,TX 76012-6311
(817)392-4477 Fax:(817)392-8460
" "m REV:02/20/07
FORI" WOR
WATER ENGINEERING&FISCAL SERVICES
PERFORMANCE EVALUATION OF CONTRACTOR
1) CONTRACTOR&PROJECT DATA
Name of Contractor Project Name
S.J.Louis Construction of Texas Ltd. East Side 11 54-inch Water Main Phase 3
Water Engineering Inspector DOE Number
LMond Brice 6898
.Water Engineering Inspector Project Manager
[�] water[21 waste water❑ storrnDrainageE] Pavement Susan Schwinger
Initial Contract Anioutit Project Difficulty
$4,920,941.11 0 Simple 0 Routine @) Complex
Final Conti-act Amount Date
$4,983,298.16 9/17/2015
H)PERFORMANCE EVALUATION
0-Inadequate I-Deficient 2-Standard 3-Good 4-Excellent
ELEMENT WEIGHT x APPLICABLE(Y N) RATING(0-4) MAX SCORE SCORE
I Submission of Documents 2 Y 1 8 2
2 Public Notifications 5 Y 1 20 5
3 Plans on Site 5 Y 2 20 10
4 Field Supervision 15 Y 3 60 45
5 Work Performed 15 Y 3 60 45
6 Finished Product 15 Y 3 60 45
7 Job Site Safety 15 Y 3 60 45
8 Traffic Control Maintenance 15 Y 1 60 15
9 Daily Clean Up 5 Y 20
10 Citizen's Complaint Resolution 5 Y 1 20 5
11 Property Restoration 5 Y 2 20 to
12 After Hours Res once 5 Y 2 20 10
13 Project Completion 5 Y 20
TOTAL ELEMENT SCORE(A) 237
BONUS POINTS(25 Maximum)(3)
TOTAL SCORE(TS) 237
III)CONTRACTOR'S RATING
Maximum Score(.MS)=448 or stun of applicable element score maximums which= 448
Rating([TS/MS]*100%) 237 448 = 53%
Performance Category Standard
<20%=Inadequate 20%to<40%=Deficient 40%to<60%=Standard 60%to<80%=Good ?M%=Excellent
Inspector's Comments(INCLUDING EXPLANATION OF BONUS POINTS AWARDED)
Signature Inspector /—"I I Signature Contractor
Signature Inspector's Supervisor d
CONTRACTOR'S COMMENTS
WATER ENGINEERING&FISCAL SERVICES
The City of Fort Worth-1000 Throckmorton Street®Fort Worth,TX 76012-6311
(817)392-4477•Fax:(817)392-8460
FORTWORTH
September 17,2015
SJ.Louis Construction of Texas
P.O.Box 834
Mansfield,TX 76063-834
Re:Acceptance Letter
Project Name: East Side 1154"Water Main Phase 3
Project Type: Water/Sanitary Sewer
Project N2: P265-6081400369,P262-6081400369,P275-7081400369
DOE.N2: 6898
Contract X2: 43993 Dated: 11/12/2012
Gentleman:
On August 11,2014 a final inspection was made on the subject project. There were punch list items identified at
the time. The punch fist items were completed on September 05,2014. 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 September 05,2014,which is the date of punch Est completion and
will extend for(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) 392-6054
Yours Truly,
Tony Sholola,P.E.,Engineering Manager
TS
cc: John Carmen,P.E.,Director,Water Department
Andy Cronber&P.E.,Assistant Director,Water Department
Captain Michael Skains,Fire Deportment
Bill Lundval,Sanitary Sewer Systems Superintendent,Water Department
Roger Hauser, Water Systems Superintendent,Water Department
Susan Schwinger,P.E.,Project Manager
David R Johnson,Supervisor,Water Engineering
Raymond Brice,Inspector,Water Engineering
Daniel Stoutenburg,P.E.Freese and Nichols,Consultant
SJ.Louis Construction of Texas,Ltd,Contractor
File
WATER DEPARTMENT
ENGINEERING AND FISCAL SERVICES
THE CITY OF FORT WORTH * 1000 THROCKMORTON STREET * FORT WORTH,TEXAS 76102
817-392-8240 * FAx 817-392-8195
16'3 Printed on recycled paper