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HomeMy WebLinkAboutContract 46271-FP3Depart DOtt,_ �a.;� ate , f. Project Manager Risk Management __ D.O.E. Brotherton in 40°11 CFA Westerman/Scanned o t 14 The Proceeding people have been Contacted concerning the request for final payment & have released this project for such payment. Clearance Conducted By Shameka Kennedy nt of TP &W Const. Services r .L EMAILIED 0 Novo 2015 Initials (1 c ,rr RT WORTH rATION AND PUBLIC WORKS )F PROJECT COMPLETION c:nsEC CONTRACT Na 'ILP4 7/ UFA Seam/led 1141fr D.O.E. Ns: 7281 CS-ft 114-1-71r Regarding contract 117281 for WEST FORK RANCH PH 8B-STORM DRAIN as required by the 462 al / TRANSPORTATION & PUBLIC WORKS as approved by City Council on N/A through M&C N/A the director of the TRANSPORTATION & PUBLIC WORKS upon the recommendation of the Assistant Director of the Transportation & Public Works Department has accepted the project as complete. Original Contract Prices: Amount of Approved Change Orders: Revised Contract Amount: Total Cost Work Completed: Less Deductions: Liquidated Damages: Pavement Deficiencies: Total Deth c.tinn Amount: Total Cost Work Completed: Less Previous Payments: Final Payment Due Recommended for Acceptance Asst. Director, TPW -Infrastructure Design and Construction c III Accepted Director, LANSPORTATION & PUBLIC WORKS ieme Asst. City Manager Comments: C205-541200-202760233883 $135,747.21 $70,581.00 N� 1 $206,328.21 $206,328.21 Days @ $210.00/ Day $206,328.21 $0.00 $206,328.21 //-2 -JC Date Date /7 9 —Kr Date OFFICIAL RECORD CITY SECRETARY FT. WORTH, TX FORT WORTH CITY OF FORT WORTH FINAL PAYMENT REQUEST Contract Name WEST FORK RANCH PH 8B Contract Limits Project Type STORM DRAIN City Project Numbers 02338 DOE Number 7281 Estimate Number 1 Payment Number 1 For Period Ending 9/24/2015 CD City Secretary Contract Number 117281 Contract Time 180;D Contract Date Days Charged to Date 250 Project Manager Buckley Contract is 100.00 Complete Contractor BURNSCO CONSTRUCTION,INC. i 6331 SOUTHWEST BLVD FORT WORTH, TX 76132 Inspectors LAYER / DOVERS i I� I f i i i I Thursday,September 24,2015 Page 1 of 4 6�7 City Project Numbers 02338 DOE Number 7281 Contract Name WEST FORK RANCH PH 8B Estimate Number I Contract Limits Payment Number 1 Project Type STORM DRAIN For Period Ending 9/24/2015 Project Funding STORM DRAIN Item Description of Items Estimated Unit Unit Cost Estimated Completed Completed No. Quanity Total Quanity Total ----------- -- — — ---------- 2 48"RCP CLASS III 10 LF $119.00 $1,190.00 10 $1,190.00 3 39"RCP CLASS III del co#1 59 LF $94.00 $5,546.00 59 $5,546.00 4 36"RCP CLASS lII 98 LF $78.00 $7,644.00 98 $7,644.00 5 33"RCP CLASS III 295 LF $67.00 $19,765.00 295 $19,765.00 6 27"RCP CLASS 111 270 LF $50.00 $13,500.00 270 $13,500.00 7 24"RCP CLASS 111 177 LF $45.00 $7,965.00 177 $7,965.00 8 21"RCP CLASS 111 163 LF $40.00 $6,520.00 163 $6,520.00 10 10'CURB INLET 10 EA $3,200.00 $32,000.00 10 $32,000.00 i 12 CONCRETE RIPRAP 42 SY $50.00 $2,100.00 42 $2,100.00 13 4'STORM JUNCTION BOX 1 EA $3,650.00 $3,650.00 1 $3,650.00 14 UNCLASSIFIED EXCAVATION BY PLAN 299 LF $5.00 $1,495.00 299 $1,495.00 15 TRENCH SAFETY o 1412 LF $0.50 $706.00 1412 $706.00 16 SEEDING 1253 SY $0.27 $338.31 1253 $338.31 17 TOPSOIL 209 CY $7.10 $1,483.90 209 $1,483.90 18 6'x3'RCB CO#I 350 LF $233.30 $81,655.00 350 $81,655.00 19 T STORM JUNCTION BOX CO#1 I EA $5,900.00 $5,900.00 1 $5,900.00 20 6'X3'FW-O HEADWALL CON 1 EA $8,400.00 $8,400.00 1 $8,400.00 21 POTHOLE GAS LINES CO#I 1 EA $6,470.00 $6,470.00 1 $6,470.00 Sub-Total of Previous Unit $206,328.21 $206,328.21 P r r p4p ki E Y l i Thursday,September 24,2015 Page 2 of 4 1 z 4 8 E City Project Numbers 02338 DOE Number 7281 Contract Name WEST FORK RANCH PH 8B Estimate Number 1 Contract Limits Payment Number 1 Project Type STORM DRAIN For Period Ending 9/24/2015 Project Funding Contract Information Summary Original Contract Amount $135,747.21 Change Orders Change Order Number 1 $70,581.00 Total Contract Price $206,328.21 Date °3 C7°�a� Total Cost of Work Completed $206,328.21 ► r y Less %Retained $0.00 Net Earned $206,328.21 fQ 5 Ins ecti ► r Date Earned This Period $206,328.21 Retainage This Period $0.00 Dat �' Less Liquidated Damages Project Mana Days @ /Day $0.00 Date LessPavement Deficiency $0.00 t. irec or/TPW-Infrastructure Design and Construction Less Penalty $0.00 Date A/zA Less Previous Payment $0.00 Direc /Contracting Depart ent d�-I',) Plus Material on Hand Less 15% $0.00 ic7 Balance Due This Payment $206,328.21 I i i i i Thursday,September 24,2015 Page 3 of 4 City Project Numbers 02338 DOE Number 7281 Contract Name WEST FORK RANCH PH 8B Estimate Number 1 Contract Limits Payment Number 1 Project Type STORM DRAIN For Period Ending 9/24/2015 Project Funding Project Manager Buckley City Secretary Contract Number 117281 Inspectors LAYER / DOVERS Contract Date Contractor BURNSCO CONSTRUCTION,INC. Contract Time 180 CD 6331 SOUTHWEST BLVD Days Charged to Date 250 CD FORT WORTH, TX 76132 Contract is .000000 Complete CITY OF FORT WORTH SUMMARY OF CHARGES Line Fund Account Center Amount Gross Retainage Net Funded i i Total Cost of Work Completed $206,328.21 Less %Retained $0.00 Net Earned $206,328.21 Earned This Period $206,328.21 i 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 i Balance Due This Payment $206,328.21 w f E Thursday,September 24,2015 Page 4 of 4 i FORTWORTH rev 03/05/07 TRANSPORTATION& PUBLIC WORKS FINAL STATEMENT OF CONTRACT TIME FINAL STATEMENT NO.:I NAME OF PROJECT: West Fork Ranch Phase 813 PROJECT NO.: 2338 CONTRACTOR: Burnsco C011SULICtion DOE NO.: 7281 PERIOD FROM 05!18/15 TO: 09/14/15 FINAL INSPECTION DATE: 30-Sep-15 WORK ORDER EFFECTIVE:5/1&2015 CONTRACT TIME: 180 0 W004 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. 20. 21. 22. 8. 23. 9. 24. (). 25. 26. 27. 13. 28. 14. 29. fil 30. 31. SAT,SUN, RAIN,TOO WET, UTILITIES DAYS TOTAL & HOLIDAYS &TOO COLD RELOCATIONS OTHERS* CHARGED DAYS THIS 250 PERIOD PREVIOUS PERIOD TOTALS 250 TO DATE *REMARKS: xd -2! RA(:'T0f DATE ECTOR DATE ENGINEERING DF PAIU'MENT The City of Fort Worth 1000'flirockrnortotiStreet Fort Worth,TX 76012-6311 (817)392-7941 •Fax:(817)392-7845 m > 0 -nom 7,7 S O o wry m s, —4 m -r > z 0 r ° a ' = k `.n > m a`rr 4t m rrr C— r- 0 r a m e U p 0 n C7 � J) w W i fln M rrr .m r9 CJ 0 m rva U) M n a7 '> n M I In I 4 z Z > S -4 U 0 0 � ftB CY ;7 5. R} In 0 i 0 a 191 V'X rrro ry� Q vti h'.:b PJ C^J C«3 <„ IM1A Ne,4 ry�t m n,A �.I 47 Gb �a Pk) 41- PAN i � C? h.) PJY CTY P,L? t97 tT ea o .. �p UM1 ft'F5 w hal P}} U7 ' t• J Ca � -� - Rwtw q "tl gyp- IQ tk1 fl4 C�J W -,I C 0� C13 C.0 Ld M CL rn nre twm �ry C"r C7'. W PoMr 1� uYD Sz © 0 .ter 414 G In rr) 1 "r* (Y4 Fri rl n ={ C p 7 > 0 :a,* T TO 7111 t� to rl) 4A W ' arve wo au u er+1 o s w"� o aar tea ry ii „ tr 1 m cr a � rn Q r t mi to z CL J J v`I CA} 1 G;9 m X x k a \ . 3 C > ww/ CL � �k\k\§/\\E\ � \ \ \\/j\�§/}(\ / \ � \ q { a $ 9 2 / m \ G7$%%$2mg\ \ \ k �e&ma0 & ET C,E ] §*®§\, 9ƒz @m \/} -2 2.0 ƒgg � j( @ ( . 2 . j I � | � ) � __---m-ec ~ O j : \/®] m $$$ ) 8Qm I-f-A _-_-t\ y7®C" /2), 0\§82 � ( � . � 2 a § � \ \ �,} \ \ } - \ \ °�. \ \ , \ \( 2 / �� } � ��� / . . �, , . � � � \ § / \ \ \ � : ) \ Z � � �, \\ / \ \ � . \y , , ' �� \ � �. \� . \ `% � . �y( � . � \ � � � � ; \\ . \ � � � �: . % . � 9 Z > y 2 ) ° j `» ^ \ \ a � ��. � � � . 2 \ \ �> � y \ : / i � � . � � i FORTWORTHREV:02/22/07 TRANSPORTATION AND PUBLIC WORKS CONTRACTOR'S EVALUATION OF CITY 1)PROJECT INFORMATION Date: Le-PL32/2015_____ Maine of Contractor Project Name Burnsco Construction West Fork Ranch Phase 813 DOE Inspector Project Manager Jim Diestel Pat Buckley DOE Number jPrqjectDfffic1111V T)Ve of Contract 7281 10 Simple 0 Routine O Complex ❑ Water ❑ Waste Water 121 Storm Drainage❑ Pavement Initial Contractknount Final Contract Arnow nt $135,747.21 $206,328.21 11)PERFORMANCE EVALUATION 0-Inadequate I -Deficient 2-Standard 3-Good 4-Excellent ELEMENT tl RATING ELEMENT TRATING 1 (0-4) L (0-4) INSPECTION EVALUATION PLANS&SPECIFICATIONS I Availability of Inspector q I Accuracy of Plans to Existing Conditions 2 Knowledge of Inspector --7F-7� Clarity&Sufficiency of Details 3 Accuracy of Measured Quantities —3 Applicability of Specifications q 4 Display Of Professionalism 4 Accuracy of Plan Quantities 5 Citizen Complaint Resolution PROJECT MANAGER EVALUATION 6 Performance-Setting up Valve Crews,Labs I Knowledge And/Or Problem Resolution_ ADMINISTRATION 2 Availability of Project Manager I Change Order Processing Time 3 Communication Lf Conflicts 2 Timliness of Contractor Payments Resolution of Utility PBid Opening to Pre-Con Meeting Timefi•ame 111)COMMENTS&SIGNATURES COMMENTS Signature Contractor Signature DOE Inspector Signature DOE Inspector's Supervisor INSPECTOR'S COMMENTS TRANSPORTATION AND PUBLIC WORKS The City of Fort Worth•1000 Throckrnotton Street•Fort Worth,TX 76012-6311 (817)392-7941 •Fax:(817)392-7845 FORTWORTHREV:02/20107 `"" mwmwwio TRANSPORTATION AND PUBLIC WORDS PERFORMANCE EVALUATION OF CONTRACTOR I) CONTRACTOR&PROJECT DATA Nanre ofContaclor Project Name Burnsco Construction West Fork Ranch Phase 8B DOE Inspector DOE Number Jim Diestel 7281 DOE Inspector Project Manager ❑ Water ❑ Waste Water 121 Storm Drainage❑ Pavement Pat Buckley Initial Contract Amount Projecl Dffficully $135,747.21 O Simple O Routine O Complex Final Contract Amount Date $206,328.21 9/30/2015 II)PERFORMANCE EVALUATION 0-Inadequate l-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 4 8 8 2 Public Notifications 5 N 3 Plans on Site 5 Y 4 20 20 4 Field Supervision 15 Y 4 60 60 5 Work Performed 15 Y 4 60 60 6 Finished Product 15 Y 4 60 60 7 Job Site Safety 15 Y 3 60 45 8 Traffic Control Maintenance 15 Y 4 60 60 9 Daily Clean Up 5 Y 3 20 15 10 Citizen's Complaint Resolution 5 N 11 Property Restoration 5 Y 4 20 20 12 After Hours Response 5 N 13 Project Completion 5 Y 4 20 20 TOTAL ELEMENT SCORE(A) 368 BONUS POINTS(25 Maximum)(B) TOTAL SCORE(TS) 368 111)CONTRACTOR'S RATING Maximum Score(MS)=448 or sum of applicable element score maximums which= 388 Rating(ITS/MS] *100%) 368 / 388 = 95% Performance Category Excellent <20%=Inadequate 20%to<40%=Deficient 40%to<60%=Standard 60%to<80%=Good >_80%=Excellent Inspector's Comments(INCLUDING EXPLANATION OF BONUS POINTS ANVARDED) Signature DOE Inspector Signature Contractor ` Signature DOE Inspector's Supervisor CONTRACTOR'S COMMENTS TRANSPORTATION AND PUBLIC WORKS t The City of Fort Worth•1000 Throckmorton Street•Fort Worth,Tai 76012-6311 (817)392-7941 •Fax:(817)392-7845 CONSENT OF OWNER ❑ SURETY COMPANY ARCHITECT ❑ CONTRACTOR ❑ TO FINAL PAYMENT SURETY ❑ Conforms with the American Institute of OTHER Architects,AIA Document G707- Bond No 022050615 PROJECT: West Fork Ranch Phase 8B-Water,Sanitary Sewer,and Storm Drain Improvements (name, address) Fort Worth,TX TO (Owner) PULTE HOMES OF TEXAS,L.P.AND CITY OF FORT PROJECT NO: WORTH CONTRACT FOR: 4800 Regent Blvd. Suite 100 West Fork Ranch Phase 8B-Water,Sanitary Sewer,and Storm Drain Improvements Irving TX 75063 CONTRACT DATE: CONTRACTOR:BURNSCO CONSTRUCTION, INC. 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) LIBERTY MUTUAL INSURANCE COMPANY 175 Berkeley Street Boston MA 02116 , SURETY COMPANY on bond of (here insert name and address of Contractor) . BURNSCO CONSTRUCTION, INC. 6331 Southwest Boulevard Benbrook TX 76132 , CONTRACTOR, hereby approves of the 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 (here insert name and address of Owner). PULTE HOMES OF TEXAS, L.P.AND CITY OF FORT WORTH 4800 Regent Blvd. Suite 100 Irving TX 75063 OWNER, as set forth in the said Surety Company's bond, IN WITNESS,WHEREOF, the Surety Company has hereunto set its hand this 5th day of October,2015 F LIBERTY MUTUAL INSURANCE COMPANY Sure Company Attest:Robbi Morales ZG/2�� �Z(�J fijJl (Seall): Signatfire of Authorized Representative Sophinie Hunter Attorney-in-Fact E' Title NOTE; This form is td be used as a companion document to AIA DOCUMENT G706, CONTRACTOR'S AFFIDAVIT OF PAYMENT OF DEBTS AND CLAIMS, Current Edition ONE PAGE } I 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, Certificate No.7111257 t American Fire and Casualty Company Liberty Mutual Insurance Company The Ohio Casualty Insurance Company West American Insurance Company , I i POWER OF ATTORNEY i KNOWN ALL PERSONS BY THESE PRESENTS: That American Fire&Casually Company and The Ohio Casualty Insurance Company are corporations duly organized under 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 WestAmerican Insurance Company is a corporation duly organized under the laws of the State of Indiana(herein collectively called the'Companies'),pursuant to and by authority herein set forth,does hereby name,constitute and appoint, Don E.Cornell;Kelly A:Westbrook;Ricardo J.Reyna;Robbi Morales;Sophinie Hunter;V .DeLene Marshall all of the city of Dallas state of Tx individually ifthere be more-than one named,its true-and.lawful attomey In fact to make,execute,seal,acknowledge and deliver,for and on its behalf as surety and as its act:and-dead,any_and all undertakings,bon ds,_recagmzanees and other surety obligations in.pursuance of these presents and shall be as binding upon the Companies as if they Bove been:duly signed by Ihe:president and attested.by the secretary of the Companies in[heir 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 soils of the Companies have been affixed thereto this 11th day of September ` '2015 No CAS Div INS ,NSUq ,tNSUR American Fire and Casualty Company -00 Q-% � °R�rFO'S'!j, yJ�o�'oR;rR9y �JPo"`FORatq"br Q�oPptr�t<` The Ohio Casualty Insurance Company N < 1906 O o 1919 Liberty Mutual Insurance Company m o 1912 ° 1991 A West merican Insurance Company N �bN'+�araes°�?Ja dy�r;at-t�s`Q�Jr aj"`rr�ontsr'p2 '� �:uutF �' � d * f CD By. n A O -STATE OF PENNSYLVANIA ss David M.Care ,Assistant Secretary ca - COUNTY OF MONTGOMERY c d =3 On this 11 th day of September 2015 before me personally appeared David M. Carey,who acknowledged himself to be the Assistant Secretary of American Fire and r0 F' 0 to .Casualty Company,Liberty Mutual Insurance Company,The Ohio Casualty Insurance Company,and West American Insurance Company,and that he,as such,being authorized so to do, >,w p execute[he foregoing instrument for the purposes therein contained by signing on behalf of the corporations by himself as a duly authorized officer. O C m` > 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. o pN 5A PAS, COMMONWEALTH OF PENNSYLVANIA �,{���) y�J/� M ��oF�otnveyrF!! Notarial Seal �a� y`" ((� G'.� O d C'N t•. v �,v Teresa Pastella,Notary Public By; I O y - of Plymouth Two.,Montgomery County Teresa Pastella,Notary Public L a �P My Commission Expires March 28,2017 ej O y�rvSYL�P��' Member,PennsylvaniaAssocallonofNotaries O E O Aqy PU0 a.. � e This Power of Attorney is made and executed pursuant to an by authority of the following By-laws and Authorizations of American Fire and Casualty Company,The Ohio Casualty Insurance to o `6 , Company,Liberty Mutual Insurance Company,and West American Insurance Company which resolutions are now in full force and effect reading as follows: .. W ARTICLE IV-OFFICERS-Section 12.Powerof Attorney.Any officer or other official of the Corporation authorized for that purpose in writing by the Chairman or the President,and subject O Cn rn +; to such limitation as the Chairman or the President may prescribe,shall appoint such attorneys-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 undertakings,bonds,recognizances and other surety obligations. Such attorneys-in-tact,subject to the limitations set forth in their respective E 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 m 0 M 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 attorney-in-fact under .>CD 4 ', the provisions of this article may be revoked at any time by the Board,the Chairman,the President or by the officer or officers granfing such power or-authority. It ar N (a r ARTICLE XIII-Execution of Contracts-SECTION 5.Surety Bonds and Undertakings.Any officer of the Company authorized for[hat purpose in writing by the chairman or the president, E 00, > i? and subject to such limitations as the chairman or the president may prescribe,shall appoint such attorneys-in-fact,as may be necessary to act in behalf of the Company to make,execute, M o = seal,acknowledge and deliver as surely any and all undertakings,bonds,recognizances and other surety obligations. Such attorneys-in-fact subject to the limitations set to in their �Z v respective powers of attorney,shall have full power to bind[he Company by their signature and execution of any such instruments and to attach thereto the seal of the Company. When so O o executed such'instruments shall be asbinding as if signed by the president and attested by the secretary. o Certificate of Designation-The President of the Company,acting pursuant io the Bylaws of the Company,authorizes David M.Carey,-Assistant-Secretary to appoint such attorneys-in- ~r- fact as maybe necessary to act on behalf of the Company:to make=execute,seal,acknowledge and deliver sssurely any and all undertakings'bonds,recognizances and other surety obligations. _ Authorization-By unanimous consent of lhe.Cpmpany's Board of Directors,the Companyconsentslhat facsimile or mechanically reproduced signature of any assistant secretary of the Company,wherever appearing upon a certified dopy of-any-power of attorney issued by the Compahy.in connection wllh surety 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 Amer fcan Fire and Casually Company,The Ohio Casualty Insurance Corripany liberty Mutual Insurance Company,and WestAmerican Insurance Company do hereby certify that the original power of,pliompyolwhlch the foregoing:is a full true-and correctfcopy'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 day of �C � � -120 . . �F.�o>tivoxgpa9�� -�J�Prroay�9y -,,�J�oryorcgra'YrF... ���oePCVkr�ylt` . . �. I 1906 0 . 0 1919 n > 1912 ° Q V 1991 a By: Gregory W.Davenport,Assistant Secretary i V 29 of 500 i LMS_12873_122013 t 0 Libel �Mutua SURETY Important Notice TO OBTAIN INFORMATION OR TO MAKE A COMPLAINT: You may write to Liberty Mutual Surety at: Liberty Mutual Surety Interchange Corporate Center 450 Plymouth Road, Suite 400 Plymouth Meeting, PA 19462-8284 You may contact the Texas Department of Insurance to obtain information on companies, coverages, rights or complaints at: 1-800-252-3439 You may write the Texas Department of Insurance: P. O. Box 149104 Austin, TX 78714-9104 Fax: (512) 475-1771 Web: http://www.tdi.state.tx.us E-mail: ConsumerProtection @,tdi.state.tx.us I i Premium or Claim Disputes 8 Should you have a dispute concerning a premium, you should contact the agent first. If you have a dispute concerning a claim, you should contact the company first. If the dispute is not resolved, you may contact the Texas Department of Insurance. Attach This Notice To Your Policy: i i This notice is for information only and does not become a part or condition of the attached document. I I I LMIC-3500 i AFFIDAVIT STATE OF TEXAS COUNTY OF TAP.RANT Before me, the undersigned authority, a notary public in the state and county aforesaid, on this clay personally appeared John Burns, President Of Burnsco construction, Inc., 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; West Fork Ranch 8B -Water, Sanitary Se r, Storm Drain Improvements BY �. John Burns, President Subscribed and sworn before me on this date 6th of October, 2015. No6y Public Tar-rant Y MARY PANNELL rrant County, Texas ,.o,�. �.';.,, �S Notary Public,State of Texas MY Commission Expires " +r October 19, 2018 Ear�Er I i ..�_Member 3, 201S rl r.JOhil S U f 11 3ufnsco Construction, ;n-. 5331 Southwest Blvd, 3enhrook,Texas 76132 Contract fOr Y.I.-st For'( Ranch, Phase SB CoE:\jV Project No.02333 CDFb!1 CRA No.201='.--053 Coil±/ DOE No.7281 Dea,-John Burns: This 12;Cer will docurna t that PUi`° DM=-S of Texas, L.P.confirms tha_ Burnsco Construcia-n, Inc. has cornpl2,ed the Work associated vAth the abode-referenced contract in an appropriate time frame, subject to coirnpledon Oi any warrant; or mairitena lice work as identified and requirzd by-the City o'i Fort bVorth, and that no liquidated damages will be assessed by Pulte Homes in connection with the Work. Pulte Homes of TX, L.P. By: Curt M. Millward Land Development Project Manager Cc: City of Fort Worth r I z I I