HomeMy WebLinkAboutResolution - 2022-R0431 - Change Order 2 Contract 14949 with Landmark StructuresResolution No. 2022-RO431
Item No. 5.7
October 25, 2022
RESOLUTION
BE IT RESOLVED BY THE CITY COUNCIL OF THE CITY OF LUBBOCK:
THAT the Mayor of the City of Lubbock is hereby authorized and directed to execute
for and on behalf of the City of Lubbock, Change Order No. 2 of Contract No. 14949 for 50th
Street and Milwaukee Avenue 2.0 MG Elevated Storage Tanks as per RFP 20-14949-TF, by
and between the City of Lubbock and Landmark Structures I, L.P., of Fort Worth, Texas, and
related documents. Said Change Order is attached hereto and incorporated in this resolution
as if fully set forth herein and shall be included in the minutes of the City Council.
Passed by the City Council on October 25, 2022
ATTEST:
Rebec a Garza, City Secr t
APPROVED AS TO CONTENT:
Erik Rejino, Assistant City Manager
APPROVED AS TO FORM:
r
Kelli Leisure, Assistant City Attorney
ccdocs/RES.Change Order #2 Contract 14949 -- 501 Street and Milwaukee Avenue 2.0 MG Elevated Storage Tanks
10.11.22
DocuSign Envelope ID: 506F4165-6580-4F93-972F-822CEB60D7D4
Office of Purchasing and Contract Management
Change Order
Contract No: 14949
Contractor: Landmark Structures, LP
Change Order No: 002 V
Contract Title: 50`h Street and Milwaukee Ave. 2.0 MG Elevated
Storage Tanks
Bid/RFP No: RFP 20-14949-TF
Project No: 92452.9241.30000
"Change Order" means a written order to a Contractor, executed by the Owner, in accordance with the Contract authorizing an addition to, deletion
from, or adjustment or revision of the requirements of the Contract documents, or an adjustment to the compensation payable to the Contractor, or to
the time for performance of the Contract and completion of the project, or a combination thereof, which does not alter the nature of project and is an
integral part of the project objective. Adjustments to "Estimated Quantities" to a line time in a Unit Price Contract do not require a Change Order. All
work that alters the nature of the construction or that is not an integral part of the project objective must be let out for public bid.
Description of Change (alteration, deviation, addition, or deletion) caused by conditions encountered during construction not covered by the
CO-002 Reconciliation Change Order includes:
• Reconciliation of contract, see attached list of overruns / underruns and contract modifications, total net credit this change
order ($82,755.30)
• CP-002 Expansion Joint Materials Change — ($4,600.00)
• CP-003 Removal of Pedestal Blasting from 5011 Street EST — ($13,580.00)
• CP-004 Fiber Optic Routing Change - $3,400.00
• CP-005 Elec. Design Development (inverter, grounding, IT receptacles.) - $7,042.50
• CP-006 Early Removal of Office Trailer — ($3,500.00)
• Final Completion Time Extension of 233 days
• Reconciliation Pay Application #21with Release of Retainage — Covering 4/26.12022 to 9,25'2022 - will be issued for
payment upon final completion and submission of all required close-out Documents
Where the Change Order is negotiated, the Change Order must be fully documented and itemized as to costs, including material quantities, material
costs, taxes, insurance, employee benefits, other related costs, profit and overhead. Where certain unit prices are contained in the initial Contract, no
deviations are allowed in computing negotiated change order costs.
ITEMIZED COSTS MUST BE FULLY DOCUMENTED AND ATTACHED TO THIS FORM.
ITEM
DESCRIPTION
AMOUNT
A.
ORIGINAL CONTRACT VALUE:
$10,640,600.00
B.
AMOUNT OF THIS CHANGE ORDER: Note: Council approval required if (+ -) $50,000
$82 755.30
COST CENTER: 4545 ACCOUNT: 92452.9241.30000
C.
PERCENT OF CONTRACT VALUE THIS CHANGE ORDER B/A)
0.770/
D.
AMOUNT OF PREVIOUS CHANGE ORDERS:
$0
E.
TOTAL AMOUNT OF ALL CHANGE ORDERS B+D)
$82,755.30)
F.
PERCENT OF CONTRACT OF ALL CHANGE ORDERS (E/A): 25% maximum)
0.77%
G.
NEW CONTRACT AMOUNT A+E):
$10 557 844.70
It is mutually agreed that the above dollar amount and the time extension, as applicable, as set forth in this Change Order constitutes full compensation
to the Contractor for all costs, expenses and damages to the Contractor, whether direct, consequential or otherwise, in anyway incident to, or arising
out of, or resulting directly or indirectly; from the work performed or modified by the Contractor under this Change Order.
This Chance Order is not valid without the followine signatures (please sign in order and return 3 originals with the Contract Cover Sheet to
Purchasin and Contract Management department):
10/7/2022 R04 1 oni2o22
�� jFidUtQFec Date (2) Proiect Arch itec neineer Date
01
Date
/ f% <4lals�
Date
to. •
Date
0-1!'7r
Date
—DS
Rs n PUR-45 (Rev 08 2018)
UocuSlgn tnvelope IU: b06F4165-6580-4F93-972F-822CEB60D7D4
00 require a Contract
(7)
10/25/2022
Date (ity Secretary
Council Date: October 25, 2022 Agenda Item #: 5.7
10/25/2022
Date
#: 2022-RO431
PUR-45 (Rev 08 2018)
Uocubign tnvelope IU: bUbf41bb-6bt$U-4F93-912F-822GEB60D71)4
Project: 501h Street and Milwaukee AVE 2.0 MG EST Project Number:
Owner: City of Lubbock
Contractor: Landmark 1683 -1683
Engineer: Freese and Nichols, Inc. LUB18410
Change Order No.: 002 Date: 10/7/2022
Make the following additions, modifications, or deletions to the Work described in the Contract Documents:
Reconciliation CO-002
Contract Modifications
CP-002 Exp. Joint Materials Change ($4,600.00)
50th Street EST, Remove Ped.
CP-003 Blast ($13,580.00)
CP-004 Fiber Optic Routing Change $3,400.00
Elec. Design Development,
CP-005 (inverter, grounding, IT rec.) $7,042.50
CP-006 Early removal of office trailer ($3,500.00)
CP-007 Time Extension 268 days
Item Description of Item Bid Value Value Credit Addition
501h Street Elevated Storage Tank
FA.10 Connection to Existing
50 24" Water Line ($20,000.00)
57 FB.01 Security Improvements $65,000.00 $39,241.10 ($25,758.90)
Milwaukee Ave. Elevated Storage Tank
122 MB.01 Security Improvements $65,000.00 $39,241.10 ($25,758.90)
($93,197.80) $10,442.50
NET Credit ($82,755.30)
The compensation in this Change Proposal is the full, complete, and final compensation for all costs the Contractor
may incur as a result of or relating to this change whether said costs are known, unknown, foreseen, or unforeseen
at this time, including without limitation, any cost for delay, extended overhead, ripple or impact cost, or any other
effect on changed or unchanged Work as a result of this Contract Amendment. The changes in Contract Times are
the complete and final adjustments for direct impacts to the ability of the Contractor to complete the Work within
the Contract Times and are the only adjustments to which the Contractor is entitled.
a Original Contract Price $10,640,600.00
b Previously Approved Change Order Amounts $0.00
c Adjusted Contract Price ( a + b) $10,640,600.00
d Change Order Amount ($82,755.30)
e Revised Contract Price ( c + d) $10,557,844.70
f Percent Change to Date: -0.77% g Change in Days this Change Order: 233
Completion Dates: Original Previous Current
vocuoign tnvewpe iu: bUbr41bb-bbt$U-4"3-5/ZF-822CEB60D7D4
Project Number:
1683 -1683
Engineer: Freese and Nichols, Inc. LUB18410
Substantial h 11/08/2021 i 12/08/2021 j 2/11/2022
Final k 01/07/2022 I 02/06/2022 m 11/1/2022
Recommended by: FREESE AND NICHOLS, INC.
0*9� 0/7/2022
Name Date
A oSYoeq Py: Landmark Construction Approv d by: CITY OF LUBBOCK
10/7/2022
E� 10/25/2022
44MFA7&A5... Date Na Date
Project: 501h Street and Milwaukee AVE 2.0 MG EST
Owner: City of Lubbock
Contractor: Landmark
-- DSS
kf
DocuSign Envelope ID: 506F4165-6580-4F93-972F-822CEB60D7D4
CP-002 Expansion Joint
Materials Change
DocuSign Envelope ID: 506F4165-6580-4F93-972F-822CEB60D7D4
NICHOL E05111 S
Change Proposal
PROJECT 50th Street and Milwaukee Ave. 2.0 MG EST PROJECT NUMBER
OWNER City of Lubbock 92452.9241.30000
BUILDER Landmark Structures I, LP
DESIGNER Freese and Nichols, Inc.
CM Ryan Opgenorth
CP No. CP-002
CP Description Expansion joint materials change was approved in SD-013.1
Specification
Drawing / Detail
NOTIFICATION BY BUILDER
The Builder proposes to make the additions, modifications, or deletions to the Work described in the Contract
Documents, as shown in Attachment and requests that you take the following action:
Purpose of Change Proposal New Change Proposal
Requested Action Issue a Work Change Directive or Change Order for the described change
Basis of Compensation Lump Sum calculated using Cost of Work provisions in General Conditions
paragraph 13.01
Required Documentation - Schedule attached to show impacts and justification for requested change in
Contract Times
Total Change Proposal Amount $-4,600.00
Adjustment in Contract Time 0 days
Attachment CP-002-ExpansionJointChangeFromSStorubber-Michael Pope-Pending.pdf
Submitted By Michael Pope Date 09-27-2022
CONSTRUCTION MANAGER'S RESPONSE
Recommended Basis for Compensation:
DocuSign Envelope ID: 506F4165-6580-4F93-972F-822CEB60D7D4
Authorization to proceed with changes must be approved by the Owner through Change Order in accordance
with the Contract Documents.
Status
Recommended for Approval
Action
Final Distribution
Comments
No final comment.
Attachments
CP-002-ExpansionJointChangeFromSStorubber-Michael Pope-Pending.pdf
Response By Bret Calvert Date 09-29-2022
DocuSign Envelope ID: 506F4165-6580-4F93-972F-822CEB60D7D4
L N DFAAR K
Landmark Structures
1665 Harmon Rd
Fort Worth , Texas 76177
P: 817 439 8888
CHANGE EVENT #24 - Both - Expansion joint Change From SS to rubber
Origin:
Date Created: 5/19/2022 Created By: Michael Pope
Status: Open Scope: TBD
Type: Owner Change Change Reason: Design Development
Description: SD-013.1, Expansion joint, $4,600 documented in Submittal
Attachments: (P SD-013.1-Exoansionoint-Ran 0 enorth-Approved as Noted.pdf
Project:1683 -1683 Lubbock TX - 50th St.
3418 50th Street
Lubbock, Texas 79413
Landmark Structures Page 1 of 1 Printed on: 9/27/2022 at 03:46PM CDT
DocuSign Envelope ID: 506F4165-6580-4F93-972F-822CEB6OD7D4
FREESE
r&NIMOLS
PROJECT
OWNER
BUILDER
DESIGNER
CM
I SD No. SD-013.1
50th Street and Milwaukee Ave. 2.0 MG EST
City of Lubbock
Landmark Structures I, LP
Freese and Nichols, Inc.
Ryan Opgenorth
Builder Submittal No.
PROJECT NUMBER
92452.9241.30000
Shop Drawing
SD Description Expansion Joint
Specification
Drawing / Detail
Builder Comments
Attachment SD-01 3.1 -ExpansionJoint-Megan Droneburg-Pending.pdf
Builder's Certification: I hereby certify that this Shop Drawing has been reviewed by the Builder and is in
strict conformance with the Contract Documents as modified by Addenda, Change Orders and / or Field
Orders.
Submitted By
Megan Droneburg Date 11-30-2020
Status
Approved as Noted
Action
Final Distribution
Comments
This is approved with the understanding that a $4,600 credit is due to the City for this
substitution. A formal CP must be be drafted by Landmark to document this.
Attachments
SD-01 3.1 -ExpansionJoint-Megan Droneburg-Pending.pdf
Returned By
Ryan Opgenorth Date 12-01-2020
DocuSign Envelope ID: 506F4165-6580-4F93-972F-822CEB60D7D4
EM0182
Freese and Nilchols
Submittal Transmittal
M-13.1
PROJECT: 50th Street and Milwaukee Avenue 2.0 MG Elevated Storage Tanks PROJECT NUMBER:
OWNER: City of Lubbock 1683 & 1684
CONTRACTOR: Landmark Structures I, L.P. LUB18410
ENGINEER: Freese & Nichols, Inc.
REFERENCE DATA:
Contractor's Submittal No. SD- 13.1 Specification Section: /
Drawing No. Detailed Description: Expansion Joint
CONTRACTOR'S CERTIFICATION: I hereby certify that this submittal has been reviewed by the Contractor
and is in strict conformance with the Contract Documents as modified by Addenda, Change Orders and Field
Orders. l
CERTIFIED BY: DATE: 11/30/2020
TYPE
#
DESCRIPTION
#SENT
#RET'D
STATUS
CMR
Contractor's Modification Request
Approved
Approved as Noted
Not Approved
Revise & Resubmit
❑ Filed As Received
Final Distribution
Change Order Issued
Field Order Issued
Recommended For Approval
Returned W/O Review
Add'I Information Required
Cancelled
See Review Comments
Pending Change Order
CTR
Certified Test Report
EIR
Equipment Installation Report
O&M
Operation & Maintenance
NBC
Notification By Contractor
PCM
Proposed Contract Modification
PR
Payment Request
PP
Project Photographs
RD
Record Data
RFI
Request for Information
SAM
Sample
SCH
Schedule of Progress
SD
13
Shop Drawing
1
CSQ
Statement of Qualifications
FOR ARCHITECT
/ ENGINEER
USE ONLY
DATE RECEIVED BY DATE RETURNED BY
COMMENTS:
DISTRIBUTION
REVIEW
NO.
SENT TO.
NO.
SENT TO.
DEPT.
BY
DATE SENT
DATE RETD
DocuSign Envelope ID: 506F4165-6580-4F93-972F-822CEB60D7D4
Maxi -Joint®
Single (1) Wide Arch Expansion Joints
stylellol
Features:
• Versatile hand -built construction. Made in the U.S.A.
• Standard or custom face to face dimensions
• Wide flowing arch design
• Exceptional all directional movement capability
• Virtually eliminates sediment buildup
• Higher pressure rating than conventional
expansion joints
• Excellent chemical and abrasion resistance
• Full vacuum rating (30" Hg) in all sizes
• 2502F continuous service standard, 4002F available
• Filled arch design available
• Hot dip galvanized retaining rings standard
• Absorbs noise, vibration and shock
• Compensates for minor misalignment and offset
• Low stiffness and deflection forces
• Integrally flanged design, no gaskets required
• Simple to install and high strength
• Provides easy access to piping and equipment
• Other standard drilling available, including ASA 300,
DIN, PN, JIS, API, and Navy
• Wide variety of tube and cover elastomers available,
including Pure Gum Rubber, EPDM, Neoprene, Butyl,
Nitrile, Hypalon° Mtone Teflon° Food Grade, and more
Control Unit
■� i■
TH ism ■1 1■
..I � Note Hot
lire.■uuuuuuuuuuuuuuuurnunnuur■.�; u
.��■■ i■■\ I.. Dipped
■■■1 1■■■ _ Optional
_'\1/4" Minimum Thickness
OtherAls•
. Typical for
lastomer
Tu .:
mbedded Steel
L F/F and Multiple
Layers of Tire Cord
Reinforcement
SIZE
,,!. D.,)
Id
2
LENGTH
(IFIF
rich)
6
MAX
Pressure
(PSIG)
220
VACUUM
Rating
(inch Hg)
30
FLANGES
0. D.
(inch)
6
- 125/150
B.C.
(inch)
4-3/4
LB. (NOTE
Hole
(no.)
4
8)
Hole
(inch)
314
TH.
(inch)
7/8
Conip
(inch)
1 3/4
MOVEMENTS
Ext.
(inch)
7/8
Lateral
(inch)
1
AngUlar
(degree)
39
Torsional
(degree)
4
SPRING
Conil).
(lbs/in)
270
RATE
Ext.
(lbs/in)
340
Lateral
(lbs/in)
450
GROSS
Weight
(lbs)
7
2-1/2
6
220
30
7
5-1/2
4
3/4
7/8
1 3/4
7/8
1
33
3.8
340
420
480
8
3
6
220
30
7-1/2
6
4
314
7/8
1 3/4
7/8
1
28
3.7
400
510
540
10
4
6
220
30
9
7-1/2
8
3/4
7/8
1 3/4
7/8
1
22
3.6
550
710
590
14
5
6
220
30
10
8-1/2
8
7/8
7/8
1 314
7/8
1
18
3.4
670
880
710
17
6
6
220
30
11
9-1/2
8
7/8
7/8
1 314
7/8
1
15
3.2
820
1050
790
20
8
6
220
30
13-1/2
11-3/4
8
7/8
7/8
1 3/4
7/8
1
12
3.1
990
1160
960
29
10
8
220
30
16
14-1/4
12
1
7/8
2
1
1 1/4
17
3
960
1170
820
39
12
8
220
30
19
17
12
1
7/8
2
1
1 1/4
14
29
1,010
1,250
970
58
14
8
220
30
21
18-3/4
12
1-1/8
1
2 1/4
1 1/8
1 1/4
12
2.8
1,080
1,300
1,140
65
16
8
160
30
23-1/2
21-1/4
16
1-1/8
1
2 1/4
1 1/8
1 1/4
11
27
1,150
1,390
1,320
80
18
8
160
30
25
22-314
16
1-1/4
1
2 1/4
1 1/8
1 1/4
10
26
1,220
1.570
1,450
90
24
10
130
30
32
29-1/2
20
1-3/8
1 1/8
21/2
1 1/4
1 3/8
8
24
1,730
2,100
1,740
120
30
10
100
30
38-314
36
28
1-3/8
1 1/8
2 1/2
1 1/4
1 318
7
2.3
2,180
2,660
Z190
172
36
10
90
30
46
42-3/4
32
1-5/8
1 1/8
21/2
1 1/4
1 3/8
6
22
2,660
3,250
Z680
219
42
12
90
30
53
49-1/2
36
1-6/8
1 1/8
21/2
1 1/4
1 1/2
4.8
2.1
3,030
3,650
3,020
290
48
12
90
30
59-1/2
56
44
1-5/8
1 1/8
21/2
1 1/4
1 1/2
4.2
2
3,390
4,150
3,410
342
54
12
85
30
66-1/4
62-3/4
44
2
1 1/8
21/2
1 1/4
1 1/2
3.8
1.9
4,120
5,020
4,140
405
60
12
85
30
73
69-1/4
52
2
1 1/8
21/2
1 114
1 1/2
3.6
1.8
4,520
5,560
4,580
500
66
12
85
30
80
76
52
2
1 1/8
21/2
1 1/4
1 1/2
3.3
1.7
5,250
6,390
5,270
580
72
12
85
30
86-1/2
82-1/2
60
2
1 1/4
2 1/2
1 1/4
1 12
3
1.6
5,900
7,180
5,920
650
78
12
80
30
93
89
64
2-1/8
1 1/4
212
1 1/4
1 12
2.6
1.5
6,420
7,850
6,570
715
84
12
80
30
99-3/4
95-12
64
2-1/4
1 1/4
21/2
1 1/4
1 12
2.3
1.4
6,950
8,670
7,400
780
90
12
80
30
106-12
102
68
2-3/8
1 1/4
2 12
1 1/4
1 12
2.1
1.3
7,270
9,200
8,080 1
880
96
12
80
30
113-1/4
108-12
68
2-12
1 1/4
2 1/2
1 1/4
1 12
2
1.2
7,650
10,100
9,070
1,010
102
12
60
30
120
114-12
72
2-5/8
1 3/8
21/2
1 1/4
1 12
1.6
0.8 1
8,128
10,730
9,640
1,073
108
12
60
30
126-314
120-3/4
72
2-5/8
1 3/8
2 1/2
1 1/4
1 12
1.5
0.7 1
8,606
11,360
10.200
1,136
Noft
1.) At Parts listed are designed for 30' Hg (full raaum) and have a mmdmmn lest at 26' Hg due to Isoft attitude and evuxment
gmil lim
2) haidmumopertungfemperatureof25Ddeg Ffor 6'DM,Butyl,Hypalon, and Won; 225deg Ffor Neoprene; 210deg Ffor Nitrile;
180 deg F for Puns Gum Rubber: 30D deg F for EPDM and Butyl in ate write at 25 PSI maim um; higher pressure and bun-
Personsratio available.
6 3.) At sties an be supplied with a filled arch reducing tab movements by 50% arld mueaq the T ^g rates fourfold.
4.) FarfWprodudspedfla0onsand! hehillatimhc c+fa6.see VM1101.1and ME1101.1 GrassweloirhdudererarrgrIgs,
5.) WARIONBa Control units (sold sspard* must be used when piphtg Is rat propery andiored. Number of roes arc dependent
upon maximum fly lest Pressures. IbMislon oft may operate in pipelines mff)w p Mils at emoted temperatures and Pres-
sures, so precautlon should be taken to ensure proper hstallatlat and regular Inspection. Care 4 required to prow personnel
m the event of leakage or splash. Adequate Boor dmins are always reoenrrorded.
6.) Movements are non-conaarent. Canted General Rubber for wnaarent movemeds, and for sties not shown tip to 144' I.D.
7.) Series 11 DO and 12DD repine at& 1025,1050 and 1075.
8.) Standard 125/150 E. driNhg indudes, 1'-24- with NO 1116.1 pass 125lbA16.5 pass 1501b., 30".60" with AN 1116.1 pass
125 DU B16.47 cedes A, pass 150 lb., 72"- 108" wnh AN 816.1 Claw 125 OoJ AWWA C207 Class B
Toll Free: 800-233-6294 � generai rubber corporation Fax: 201-035-1015
Web: www.goneral-robber.com sales@general-rnbber.com
DocuSign Envelope ID: 506F4165-6580-4F93-972F-822CEB60D7D4
CP-003 Removal of Sand Blast
Requirement for 50th Street EST
DocuSign Envelope ID: 506F4165-6580-4F93-972F-822CEB60D7D4
�',12 aNICMOLS
Change Proposal
PROJECT 50th Street and Milwaukee Ave. 2.0 MG EST PROJECT NUMBER
OWNER City of Lubbock 92452.9241.30000
BUILDER Landmark Structures I, LP
DESIGNER Freese and Nichols, Inc.
CM Ryan Opgenorth
CP No. CP-003
CP Description It was determined by the City to not blast the pedestal of the 50th street EST.
Specification
Drawing / Detail
NOTIFICATION BY BUILDER
The Builder proposes to make the additions, modifications, or deletions to the Work described in the Contract
Documents, as shown in Attachment and requests that you take the following action:
Purpose of Change Proposal New Change Proposal
Requested Action Issue a Work Change Directive or Change Order for the described change
Basis of Compensation Lump Sum calculated using Cost of Work provisions in General Conditions
paragraph 13.01
Required Documentation - Detailed cost breakdown attached showing labor, materials, equipment, and all
other costs for this change
- Schedule attached to show impacts and justification for requested change in
Contract Times
Total Change Proposal Amount $-13,580.00
Adjustment in Contract Time 0 days
Attachment CP-003-50thStreetESTRemovePed.Blast-Michael Pope-Pending.pdf
Submitted By Michael Pope Date 09-27-2022
DocuSign Envelope ID: 506F4165-6580-4F93-972F-822CEB60D7D4
CONSTRUCTION MANAGER'S RESPONSE
Recommended Basis for Compensation:
Authorization to proceed with changes must be approved by the Owner through Change Order in accordance
with the Contract Documents.
Status Recommended for Approval
Action Final Distribution
Comments No final comment.
Attachments CP-003-50thStreetESTRemovePed.Blast-Michael Pope-Pending.pdf
Response By Bret Calvert Date 09-29-2022
DocuSign Envelope ID: 506F4165-6580-4F93-972F-822CEB60D7D4
From: Ryan Opgenorth
To: Lewis Robson
Cc: BRatcliffe(lmail.ci.lubbock.tx.us; Josh Kristinek(JKristinek@)mail.ci.lubbock.tx.usl; Kelly Smith; Robert Boswell;
Jessica Reyes; Bret Calvert
Subject: 50th Street and Milwaukee Ave. ESTs Pedestal Blasting
Date: Tuesday, August 24, 2021 2:39:50 PM
Lewis,
The City would like to proceed with blasting the Milwaukee Ave. EST pedestal all the way.
At this point, they are leaning towards not doing it at 50th Street but would like to evaluate that
decision for 50th Street after the Milwaukee Ave. EST pedestal blasting is complete.
Regards,
Ryan Opgenorth, P.E.
Freese and Nichols, Inc.
817-735-7399
rmo(@freese.com
This electronic mail message is intended exclusively for the individual or entity to which it is
addressed. This message, together with any attachment, may contain the sender's
organization's confidential and privileged information. The recipient is hereby notified to treat
the information as confidential and privileged and to not disclose or use the information except
as authorized by sender's organization. Any unauthorized review, printing, retention, copying,
disclosure, distribution, retransmission, dissemination or other use of, or taking of any action
in reliance upon, this information by persons or entities other than the intended recipient is
prohibited. If you received this message in error, please immediately contact the sender by
reply email and delete all copies of the material from any computer. Thank you for your
cooperation.
DocuSign Envelope ID: 506F4165-6580-4F93-972F-822CEB60D7D4
CP-004 Fiber Optic Routing
Change
DocuSign Envelope ID: 506F4165-6580-4F93-972F-822CEB60D7D4
FREESE
N05111101CHOLS
Change Proposal
PROJECT
50th Street and Milwaukee Ave. 2.0 MG EST PROJECT NUMBER
OWNER
City of Lubbock 92452.9241.30000
BUILDER
Landmark Structures I, LP
DESIGNER
Freese and Nichols, Inc.
CM
Ryan Opgenorth
CP No.
CP-004
CP Description
This field order moves the eastern CMU wall at 50th Street 4' west to avoid existing AT&T
fiber optic conduits below grade. It also adds additional fiber optic conduit at the
Milwaukee Site to connect between pull boxes installed as a result of separate contracts.
Specification
Drawing / Detail
NOTIFICATION BY BUILDER
The Builder proposes to make the additions, modifications, or deletions to the Work described in the Contract
Documents, as shown in Attachment and requests that you take the following action:
Purpose of Change Proposal New Change Proposal
Requested Action Issue a Work Change Directive or Change Order for the described change
Basis of Compensation Lump Sum calculated using Cost of Work provisions in General Conditions
paragraph 13.01
Required Documentation - Detailed cost breakdown attached showing labor, materials, equipment, and all
other costs for this change
- Schedule attached to show impacts and justification for requested change in
Contract Times
Total Change Proposal Amount $ 3,400.00
Adjustment in Contract Time 0 days
Attachment CP-004-FO-007-FiberOpticRoutingChange-Michael Pope-Pending.pdf
Submitted By Michael Pope Date 09-27-2022
DocuSign Envelope ID: 506F4165-6580-4F93-972F-822CEB60D7D4
CONSTRUCTION MANAGER'S RESPONSE
Recommended Basis for Compensation:
Authorization to proceed with changes must be approved by the Owner through Change Order in accordance
with the Contract Documents.
Status Recommended for Approval
Action Final Distribution
Comments No final comment.
Attachments CP-004-FO-007-FiberOpticRoutingChange-Michael Pope-Pending.pdf
Response By Bret Calvert Date 09-29-2022
Docusign I nvelope ID: 506F4165-6580-4F93-972F-822CEB60D7D4
Page Left
Intentionally
Blank
DocuSign Envelope ID: 506F4165-6580-4F93-972F-822CEB60D7D4
FREESE
N15111101CHOLS
Field Order
PROJECT 50th Street and Milwaukee Ave. 2.0 MG EST PROJECT NUMBER
OWNER City of Lubbock 92452.9241.30000
BUILDER Landmark Structures I, LP
DESIGNER Freese and Nichols, Inc.
CM Ryan Opgenorth
FO No. FO-007 FO Description 50th Street East CMU Wall
Alignment Change, Additional
Fiber Optic Conduit at Milwaukee
EST Site
Specification
Drawing/Detail C-1, C-2, and E-9
Make the following modifications to the Contract Documents as set forth in this Field Order pursuant to the
General Conditions of the Contract Documents. It is the Construction Manager's and Engineer's opinion that
this Field Order does not alter the Contract Price or the Contract Time. Notify the Construction Manager prior to
commencing the Work and submit a Change Proposal N the Builder does not agree with the Construction
Manager's and Engineer's opinion.
Detail Desc. This field order moves the eastern CMU wall at 50th Street N west to avoid existing AT&T
fiber optic conduits below grade. It also adds additional fiber optic conduit at the
Milwaukee Site to connect between pull boxes installed as a result of separate contracts.
Attachments FO-007-FieldOrderNo.7C-1 C-2andE-9= Ryan Opgenorth-Pending.pdf
Status Filed as Received
Action Final Distribution
Submitted By Ryan Opgenorth
Date 12-01-2021
PROPODD
SED 22' GATE
4
❑ CONCRETE PAVING
(RE: 1/DT-3)
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DocuSign Envelope ID: 506F4165-6580-4F93-972F-822CEB60D7D4
CP-005 Electrical Design
Development; Inverter,
Grounding, IT Receptical,
DocuSign Envelope ID: 506F4165-6580-4F93-972F-822CEB60D7D4
FREESE
Irl,11101CHOLS
Change Proposal
PROJECT
50th Street and Milwaukee Ave. 2.0 MG EST PROJECT NUMBER
OWNER
City of Lubbock 92452.9241.30000
BUILDER
Landmark Structures I, LP
DESIGNER
Freese and Nichols, Inc.
CM
Ryan Opgenorth
CP No.
CP-005
CP Description
Email between F&N and IOTA Engineering 2/1 /2/2021 - Identifying the need for a dry
contact from the inverter that would be capable of connecting to a PLC in order to send
an general alarm that power has failed and the UPS is on. COP for the material for the
Ground Loop, project documents specified 1 /0 tinned copper wire - to achieve UL
certification 2/0 tinned copper wire was required. Installed power outlets and conduit
from Security Cabinet to SCADA Panel for IT switch and components
Specification
Drawing / Detail
NOTIFICATION BY BUILDER
The Builder proposes to make the additions, modifications, or deletions to the Work described in the Contract
Documents, as shown in Attachment and requests that you take the following action:
DocuSign Envelope ID: 506F4165-6580-4F93-972F-822CEB60D7D4
Purpose of Change Proposal
Requested Action
Basis of Compensation
Required Documentation
Total Change Proposal Amount
Adjustment in Contract Time
Attachment
New Change Proposal
Issue a Work Change Directive or Change Order for the described change
Lump Sum calculated using Cost of Work provisions in General Conditions
paragraph 13.01
- Detailed cost breakdown attached showing labor, materials, equipment, and all
other costs for this change
- Schedule attached to show impacts and justification for requested change in
Contract Times
$ 7,042.50
0 days
Submitted By Michael Pope
CONSTRUCTION MANAGER'S RESPONSE
Recommended Basis for Compensation:
Date 09-27-2022
Authorization to proceed with changes must be approved by the Owner through Change Order in accordance
with the Contract Documents.
Status Recommended for Approval
Action Final Distribution
Comments No final comment.
Attachments
Response By Bret Calvert Date 09-29-2022
uocu5ign tnvelope lu: 5U6F4165-6580-4F93-972F-822CEB60D7D4
CP-006 Early Removal of Office
Trailer
DocuSign Envelope ID: 506F4165-6580-4F93-972F-822CEB60D7D4
;CHoLS
E05111
Change Proposal
PROJECT 50th Street and Milwaukee Ave. 2.0 MG EST PROJECT NUMBER
OWNER City of Lubbock 92452.9241.30000
BUILDER Landmark Structures I, LP
DESIGNER Freese and Nichols, Inc.
CM Ryan Opgenorth
CP No.
CP Description
Specification
Drawing / Detail
CP-006
RFI -021 - Office trailer approved to be removed for a deduct of $3,500
NOTIFICATION BY BUILDER
The Builder proposes to make the additions, modifications, or deletions to the Work described in the Contract
Documents, as shown in Attachment and requests that you take the following action:
Purpose of Change Proposal
Requested Action
Basis of Compensation
Required Documentation
Total Change Proposal Amount
Adjustment in Contract Time
Attachment
New Change Proposal
Issue a Work Change Directive or Change Order for the described change
Lump Sum calculated using Cost of Work provisions in General Conditions
paragraph 13.01
- Detailed cost breakdown attached showing labor, materials, equipment, and all
other costs for this change
- Schedule attached to show impacts and justification for requested change in
Contract Times
$-3,500.00
0 days
Submitted By Michael Pope
Date 09-27-2022
DocuSign Envelope ID: 506F4165-6580-4F93-972F-822CEB60D7D4
CONSTRUCTION MANAGER'S RESPONSE
Recommended Basis for Compensation:
Authorization to proceed with changes must be approved by the Owner through Change Order in accordance
with the Contract Documents.
Status Recommended for Approval
Action Final Distribution
Comments No final comment.
Attachments
Response By Bret Calvert Date 09-29-2022
DocuSign Envelope ID: 506F4165-6580-4F93-972F-822CEB60D7D4
CP-007 Time Extension
uucuoign r-nveiope iu: bubl-41100-bbt$U-41-y3-9f1h-822(:tB60D7D4
N15111101CHOLS
Change Proposal
PROJECT 50th Street and Milwaukee Ave. 2.0 MG EST PROJECT NUMBER
OWNER City of Lubbock 92452.9241.30000
BUILDER Landmark Structures I, LP
DESIGNER Freese and Nichols, Inc.
CM Ryan Opgenorth
CP No. CP-007
CP Description Additional contract calendar days - 65 days for Substantial Completion and 268 to final
Completion Substantial Completion Date - February 11, 2022 Revised Final Completion
Date - Nov. 1, 2022
Specification
Drawing / Detail
NOTIFICATION BY BUILDER
The Builder proposes to make the additions, modifications, or deletions to the Work described in the Contract
Documents, as shown in Attachment and requests that you take the following action:
Purpose of Change Proposal
Requested Action
Basis of Compensation
Required Documentation
Total Change Proposal Amount
Adjustment in Contract Time
Attachment
New Change Proposal
Issue a Work Change Directive or Change Order for the described change
Lump Sum calculated using Cost of Work provisions in General Conditions
paragraph 13.01
None Provided
$ 0.00
268 days
Submitted By Michael Pope
CONSTRUCTION MANAGER'S RESPONSE
Recommended Basis for Compensation:
Date 09-28-2022
DocuSign Envelope ID: 506F4165-6580-4F93-972F-822CEB60D7D4
Authorization to proceed with changes must be approved by the Owner through Change Order in accordance
with the Contract Documents.
Status Recommended for Approval
Action Final Distribution
Comments No final comment.
Attachments
Response By Bret Calvert Date 10-06-2022
DocuSign Envelope ID: 506F4165-6580-4F93-972F-822CEB60D7D4
Reconciliation Pay Application
-_ - -'" —--- W.-, -t ULA;UMtNI SUMMAHY SHEET Page 1 of 5
TO OWNER/CLIENT-
City of Lubbock
1625 13th Street, Room 204
Lubbock, Texas 79401
FROM CONTRACTOR:
Landmark Structures
1665 Harrison Rd
Fort Worth, Texas 76177
PROJECT:
1683 - 1683 Lubbock TX - 50th St.
3418 50th Street
Lubbock, Texas 79413
VIA ARCHITECT/ENGINEER:
Ryan Opgenorth (Freese and Nichols, Inc)
4055 International Piz, St. 200
Fort Worth, Texas 76109
CONTRACT FOR: Lubbock TX - 50th St. Prime Contract
APPLICATION NO: 21
INVOICE NO: 21
PERIOD: 04/26/22 - 09/25/22
OWNER'S CONTRACT NO:
CONTRACT DATE:
CONTRACTOR'S APPLICATION FOR PAYMENT The undersigned certifies that to the best of the Contractor's knowledge, information and belief, the Work covered
Application is made for payment, as shown below, in connection with the Contract. Continuation by this Application for Payment has been completed in accordance with the Contract Documents, that all amounts
Sheet is attached. have been paid by the Contractor for Work which previous Certificates for payment were issued and payments
received from the Owner/Client, and that current payments shown herein is now due.
1. Original Contract Sum
$10,640,600.00
2. Net change by change orders
$(82,755.30)
3. Contract Sum to date (Line 1 t 2)
$10,557,844.70
4. Total completed and stored to date
(Column G on detail sheet)
$10,557,844.70
5. Retainage:
a. 0.00% of completed work
$0.00
b. 0.00% of stored material
$0.00
Total retainage
(Line 5a + 5b or total in column I of detail sheet)
$0.00
6. Total earned less retainage
(Line 4 less Line 5 Total)
$10,557,844.70
7. Less previous certificates for payment
(Line 6 from prior certificate)
$10,101,259.46
8. Current payment due:
$456,585.24
9. Balance to finish, including retainage
(Line 3 less Line 6)
$0.00
CHANGE ORDER SUMMARY
ADDITIONS
DEDUCTIONS
Total changes approved in previous months by Owner/Client:
$0.00
$0.00
Total approved this month:
$88,924.70
$(171,680.00)
Totals:
$88,924.70
$(171,680.00)
Net change by change orders:
$(82,755.30)
CONTRACTOR: Landmark S yes
By: f -
Date: 9/29/2022
State of. Texas
Countyof: Tarrant ENLY MAYN LD
Subscribed and swom to before �y Milk, eIttti
me this 29th day of September, 2022 COWL � 0441�4
Notary Public: �q � �� �D i 91 a
My commission expjre$ ,I /91fr7d
ARCHITECT'S/ENGINEER'S CERTIFICATE FOR PAYMENT
In accordance with the Contract Documents, based on the on -site observations and the data comprising this
application, the Architect/Engineer certifies to the Owner/Client that to the best of the Architect's/Engineer's
knowledge, information and belief that Work is in accordance with the Contract Documents, and the Contractor is
entitled to payment of the AMOUNT CERTIFIED.
AMOUNT CERTIFIED: $456,585.24
(Attach explanation if amount certified differs from the amount applied for. Initial all figures on this Application and
on the Continuation Sheet that are changed to confirm the amount certified.)
ARCHITECT/ENGINEER:
By:
Date:
This certificate is not negotiable. The amount certified is payable only to the Contractor named herein. Issuance,
payment and acceptance of payment are without prejudice to the rights of the Owner/Client or Contractor under
this Contract.
DocuSign Envelope ID: 506F4165-6580-4F93-972F-822CEB60D7D4 UVC:UMLNI OL IAIL SHLL I Dane / nt
.11
Document SUMMARY SHEET, APPLICATION AND CERTIFICATE FOR PAYMENT, containing
Contractor's signed Certification is attached.
Use Column I on Contracts where variable retainage for line items apply.
Contract Lines
APPLICATION NUMBER: 21
APPLICATION DATE: 9/25/2022
PERIOD: 04/26/21 - 09/25/21
A
ITEM
NO.
B
DESCRIPTION OF WORK
C
SCHEDULED VALUE
D E
WORK COMPLETED
G
TOTAL %
COMPLETE COMPLETE
H
BALANCE TO
FINISH
(C - G)
1
RETAINAGE
UNIT
QTY
UNIT PRICE
VALUE
PRIOR
APPLICATION
THIS PERIOD
1
F.01 Engineering - Elevated Tank - Foundation / Basis
LS
1.0
$95,000.00
$95,000.00
$95,000.00
$0.00
$95,000.00
100.00%
$0.00
$0.00
2
F.02 Engineering - Elevated Tank - Pedestal
LS
1.0
$72,500.00
$72,600.00
$72,500.00
$0.00
$72,500.00
100.00%
$0.00
$0.00
3
F.03 Engineering - Elevated Tank - Steel Tank
LS
1.0
$62,500.00
$62,500.00
$62,500.00
$0.00
$62.500.00
100.00%
$0.00
$0.00
4
F.04 Foundation Excavation
LS
1.0
$105,000.00
$105,000.00
$105,000.00
$0.00
$105,000.00
100.00%
$0.00
$0.00
5
F.05 Foundation Placement
LS
1.0
$349,300.00
$349,300.00
$349,300.00
$0.00
$349,300.00
100.00%
$0.00
$0.00
6
F.06 Foundation - Backfill Exterior
LS
1.0
$63,250.00
$63,250.00
$63,250.00
$0.00
$63,250.00
100.00%
$0.00
$0.00
7
F.07 Concrete Pedestal - Lifts 1 / Crane / Scaffold
LS
1.0
$365,000.00
$365,000.00
$365,000.00
$0.00
$365,000.00
100.00%
$0.00
$0.00
8
F.08 Concrete Pedestal - Lifts 2-18
EA
17.0
$120,000.00
$2,040.000.00
$2,040,000.00
$0.00
$2,040,000.00
100.00%
$0.00
$0.00
9
F.09 Concrete Pedestal - Tank Floor
LS
1.0
$61,200.00
$61,200.00
$61,200.00
$0.00
$61,200.00
100.00%
$0.00
$0.00
10
F.10 Steel Tank - Materials - Plate & Accessories
LS
1.0
$307,000.00
$307,000.00
$307,000.00
$0.00
$307,000.00
100.000
$0.00
$0.00
11
F.11 Shop Fabrication
LS
1.0
$117,000.00
$117,000.00
$117,000.00
$0.00
$117,000.00
100.00%
$0.00
$0.00
12
F.12 Steel Tank - Erect - Ring Beam
LS
1.0
$45,300.00
$45,300.00
$45,300.00
$0.00
$45,300.00
100.00%
$0.00
$0.00
13
F.13 Steel Tank - Erect - Cone
LS
1.0
$105,000.00
$105,000.00
$105,000.00
$0.00
$105,000.00
100.00%
$0.00
$0.00
14
F.14 Steel Tank - Erect - Vertical Shell
LS
1.0
$85,000.00
$85,000.00
$85,000.00
$0.00
$85,000.00
100.00%
$0.00
$0.00
15
F.15 Steel Tank - Erect - Access Tube / Platform
LS
1.0
$22,500.00
$22,500.00
$22,500.00
$0.00
$22,500.00
100.00%
$0.00
$0.00
16
F.16 Steel Tank - Erect - Hoist
LS
1.0
$29,500.00
$29,500.00
$29,500.00
$0.00
$29,500.00
100.00%
$0.00
$0.00
17
F.17 Steel Tank - Erect - Floor
LS
1.0
$6,300.00
$6,300.00
$6,300.00
$0.00
$6,300.00
100.00%
$0.00
$0.00
18
F.18 Steel Tank - Erect - Roof
LS
1.0
$18,500.00
$18,500.00
$18,500.00
$0.00
$18,500.00
100.00%
$0.00
$0.00
19
F.19 Steel Tank - Field Coating - Ground Phase
LS
1.0
$202,000.00
$202,000.00
$202,000.00
$0.00
$202,000.00
100.00%
$0.00
$0.00
20
F.20 Steel Tank - Field Coating - Air Phase
LS
1.0
$120,000.00
$120,000.00
$120,000.00
$0.00
$120,000.00
100.00%
$0.00
$0.00
21
F.21 Slab on Grade
LS
1.0
$7,500.00
$7,500.00
$7,500.00
$0.00
$7.500.00
100.00%
$0.00
$0.00
22
F.22 Mechanical - Pedestal - Riser Piping
LS
1.0
$96,000.00
$96,000.00
$96,000.00
$0.00
$96,000.00
100.00%
$0.00
$0.00
23
F.23 Mechanical - Steel Tank - Riser
LS
1.0
$6,800.00
$6,800.00
$6,800.00
$0.00
$6,800.00
100.00%
$0.00
$0.00
24
F.24 Mechanical - Foundation - Base Pipe
LS
1.0
$34,500.00
$34,500.00
$34,500.00
$0.00
$34,500.00
100.00%
$0.00
$0.00
25
F.25 Mechanical - Chamber - Valves / Piping
LS
1.0
$85.000.00
$85,000.00
$85,000.00
$0.00
$85,000.00
100.00%
$0.00
$0.00
26
F.26 Clearing and Grubbing
LS
1.0
$6,500.00
$6,500.00
$6,500.00
$0.00
$6,500.00
100.00%
$0.00
$0.00
27
F.27 Site Preparation and Grading
LS
1.0
$6,500.00
$6,500.00
$2,500.00
$4,000.00
$6,500.00
100.00%
$0.00
$0.00
28
F.28 Construction Project Sign
EA
2.0
$2,500.00
$5,000.00
$5,000.00
$0.00
$5,000.00
100.00%
$0.00
$0.00
29
F.29 Hydromulch Seed
LS
1.0
$1,620.00
$1,620.00
$0.00
$1,620.00
$1.620.00
100.00%
$0.00
$0.00
30
F.30 Storm Water Pollution Plan and Erosion Control
LS
1.0
$7,500.00
$7,500.00
$7,500.00
$0.00
$7,500.00
100.00%
$0.00
$0.00
31
F.31 Construction Entrance
LS
1.0
$15,000.00
$15,000.00
$15,000.00
$0.00
$15,000.00
100.00%
$0.00
$0.00
32
F.32 Temp Fencing
LS
1.0
$7,230.00
$7,230.00
$7,230.00
$0.00
$7,230.00
100.00%
$0.00
$0.00
33
F.33 Traffic Control
LS
1.0
$7,500.00
$7,500.00
$7,500.00
$0.00
$7,500.00
100.00%
$0.00
$0.00
34
F.34 Commisioning & Startup
LS
1.0
$2.500.00
$2,500.00
$2,500.00
$0.00
$2,500.00
100.00%
$0.00
$0.00
35
FA.01.1 Site Electrical
LS
1.0
$35,000.00 1$35,000.00
$35,000.00
$0.001
$35,000.00
100.00%1
$0.00
$0.00
DocuSign Envelope ID: 506F4165-6580-4F93-972F-822CEB60D7D4 L)O(:UMLN 1 UL IAIL JHLL I rage s of b
A
ITEM
NO.
B
DESCRIPTION OF WORK
C
SCHEDULED VALUE
D E
WORK COMPLETED
G
TOTAL o/"
COMPLETE COMPLETE
H
BALANCE TO
FINISH
(C - G)
I
RETAINAGE
UNIT
QTY
UNIT PRICE
VALUE
PRIOR
APPLICATION
THIS PERIOD
36
FA.01.2 Foundation Electrical
LS
1.0
$50,000.00
$50,000.00
$50,000.00
$0.00
$50,000.00
100.00%
$0.00
$0.00
37
FA.01.3 Pedestal Electrical
LS
1.0
$75,000.00
$75,000.00
$75,000.00
$0.00
$75,000.00
100.00%
$0.00
$0.00
38
FA.01.4 Tank Electrical
LS
1.0
$40,000.00
$40,000.00
$40,000.00
$0.00
$40,000.00
100.00%
$0.00
$0.00
39
FA.01.5 SCADA Electrical
LS
1.0
$50,000.00
$50,000.00
$50,000.00
$0.00
$50,000.00
100.00%
$0.00
$0.00
40
FA.02.1 Panels
LS
1.0
$35,000.00
$35,000.00
$35,000.00
$0.00
$35,000.00
100.00%
$0.00
$0.00
41
FA.02.2 Chlorine Analyzer and PLC
LS
1.0
$25,000.00
$25,000.00
$25.000.00
$0.00
$25,000.00
100.00%
$0.00
$0.00
42
FA.02.3 RTU, Wiring
LS
1.0
$40,000.00
$40,000.00
$40,000.00
$0.00
$40,000.00
100.00%
$0.00
$0.00
43
FA.03 Tank Mixing System
LS
1.0
$45,000.00
$45,000.00
$45,000.00
$0.00
$45,000.00
100.00%
$0.00
$0.00
44
FA.04 Site Clearing, GrubbinG and Earthwork
LS
1.0
$50,000.00
$50,000.00
$50,000.00
$0.00
$50,000.00
100.00%
$0.00
$0.00
45
FA.05 Split Face CMU Fencing
LF
935.0
$220.00
$205,700.00
$205,700.00
$0.00
$205.700.00
100.00%
$0.00
$0.00
46
FA.06 8 Concrete Paving"
SY
345.0
$90.00
$31,050.00
$31.050.00
$0.00
$31,050.00
100.00%
$0.00
$0.00
47
FA.07 Concrete Swale
LS
1.0
$5,000.00
$5,000.00
$5,000.00
$0.00
$5,000.00
100.00%
$0.00
$0.00
48
FA.08 20 Water Line"
LF
59.0
$800.00
$47,200.00
$47,200.00
$0.00
$47,200.00
100.00%
$0.00
$0.00
49
FA.09 24 Line Stop"
LS
1.0
$50,000.00
$50,000.00
$50,000.00
$0.00
$50,000.00
100.00%
$0.00
$0.00
50
FA.10 Connection to Existing 24 Water Line"
LS
1.0
$20,000.00
$20,000.00
$20,000.00
$0.00
$20,000.00
100.00%
$0.00
$0.00
51
FA. 11 20 Butterfly Valve-
EA
1.0
$20,000.00
$20.000.00
$20,000.00
$0.00
$20,000.00
100.00%
$0.00
$0.00
52
53
FA.12 6 FH Assembly"
FA.13 4 Sewer Line-
EA
LF
1.0
110.0
$7,000.00
$100.00
$7,000.00
$11,000.00
$7,000.00
$11,000.00
$0.00
$0.00
$7,000.00
$11.000.00
100.00%
100.00%
$0.00
$0.00
$0.00
$0.00
54
1 FA.14 Trench Safety
LF
340.0
$5.00
$1,700.00
$1,700.00
$0.00
$1,700.00
100.00%
$0.00
$0.00
55
1 FA.15 SWPPP
LS
1.0
$5,000.00
$5,000.00
$5,000.00
$0.00
$5,000.00
100.00%
$0.00
$0.00
56
1 FA.16 Mobilization (3% of base bid)
LS
1.0
$51,350.00
$51,350.00
$51,350.00
$0.00
$51,350.00
100.00%
$0.00
$0.00
57
FB.01 Security Improvements
LS
1.0
$65.000.00
$65,000.00
$65,000.00
$0.00
$65,000.00
100.00%
$0.00
$0.00
58
59
60
FC.01 Interior Spiral Staircase
FD.01 Increase Head Range to 45'
FD.02 Remove Cross -Over Ladder
LS
LS
LS
1.0
1.0
1.0
$100,000.00
$(72,300.00)
$(5,875.00)
$100,000.00
$(72,300.00)
$(5,875.00)
$100,000.00
$(72,300.00)
$(5,875.00)
$0.00
$0.00
$0.00
$100,000.00
$(72,300.00)
$(5,875.00)
100.00%
100.00%
100.00%
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
61
FD.03 Reduce Sample Piping to one Line
LS
1.0
$(5,150.00)
$(5,150.00)
$(5,150.00)
$0.00
$(5,150.00)
100.00%
$0.00
$0.00
62
FD.04 Remove Floor Drains, Except at CL2 Analyzer
LS
1.0
$(4,500.00)
$(4,500.00)
$(4,500.00)
$0.00
$(4,500.00)
100.00%
$0.00
$0.00
63
FD.05 Replace AST Vent with Newlins Vent
LS
1.0
$(3,750.00)
$(3,750.00)
$(3,750.00)
$0.00
$(3,750.00)
100.00%
$0.00
$0.00
65
Reduce Upper Landing to Half Span, Elimminate
Secon
Second Upper Pedestal Louver
FD.07 Delete Anti -Graffiti Coating
LS
LS
1.0
1.0
$(8,875.00)
$(8,250.00)
$(8,875.00)
$(8,250.00)
$(8,875.00)
$(8,250.00)
$0.00
$0.00
$(8,875.00)
$(8,250.00)
100.00%
100.00%
$0.00
$0.00
$0.00
$0.00
66
FD.08 Delete Settlement Monitoring
LS
1.0
$(4,500.00)
$(4,500.00)
$(4,500.00)
$0.00
$(4,500.00)
100.00%
$0.00
$0.00
67
M.01 Engineering - Elevated Tank - Foundation / Basis
LS
1.0
$95,000.00
$95,000.00
$95,000.00
$0.00
$95.000.00
100.00%
$0.00
$0.00
68
69
M.02 Engineering - Elevated Tank - Pedestal
M.03 Engineering - Elevated Tank - Steel Tank
LS
LS
1.0
1.0
$75,000.00
$62,500.00
$75,000.00
$62,500.00
$75,000.00
$62,500.00
$0.00
$0.00
$75,000.00
$62,500.00
100.00%
100.00%
$0.00
$0.00
$0.00
$0.00
70
M.04 Foundation Excavation
LS
1.0
$70,000.00
$70,000.00
$70,000.00
$0.00
$70,000.00
100.00%
$0.00
$0.00
71
72
M.05 Foundation Placement
M.06 Foundation - Backfill Exterior
LS
LS
1.0
1.0
$265,000.00
$51,000.00
$265,000.00
$51.000.00
$265,000.00
$51,000.00
$0.00
$0.00
$265,000.00
$51,000.00
100.00%
100.00%
$0.00
$0.00
$0.00
$0.00
73
M.07 Concrete Pedestal - Lifts 11 Crane / Scaffold
LS
1.0
$390,000.00
$390,000.00
$390,000.00
$0.00
$390,000.00
100.00%
$0.00
$0.00
74
M.08 Concrete Pedestal - Lifts 2-15
EA
15.0
$120,000.00
$1,800,000.00
$1,800,000.00
$0.00
$1,800,000.00
100.00%
$0.00
$0.00
A
B
C
D E
G
H
1
ITEM
NO.
DESCRIPTION OF WORK
SCHEDULED VALUE
WORK COMPLETED
TOTAL
COMPLETE
%
COMPLETE
BALANCE TO
FINISH
(C - G)
RETAINAGE
UNIT
OTY
UNIT PRICE
VALUE
PRIOR
APPLICATION
THIS PERIOD
75
M.69 Concrete Pedestal - Tank Floor
LS
1.0
$81,200.00
$81,200.00
$81,200.00
$0.00
$81,200.00
100.00%
$0.00
$0.00
76
M.10 Steel Tank - Materials - Plate & Accessories
LS
1.0
$307,000.00
$307.000.00
$307,000.00
$0.00
$307,000.00
100.00%
$0.00
$0.00
77
M.11 Shop Fabrication
LS
1.0
$117,000.00
$117,000.00
$117,000.00
$0.00
$117,000.00
100.00%
$0.00
$0.00
78
M.12 Steel Tank - Erect - Ring Beam
LS
1.0
$45,300.00
$45,300.00
$45,300.00
$0.00
$45.300.00
100.00%
$0.00
$0.00
79
M.13 Steel Tank - Erect - Cone
LS
1.0
$105,000.00
$105,000.00
$105,000.00
$0.00
$105,000.00
100.00%
$0.00
$0.00
80
M.14 Steel Tank - Erect - Vertical Shell
LS
1.0
$85,000.00
$85,000.00
$85,000.00
$0.00
$85,000.00
100.00%
$0.00
$0.00
81
M.15 Steel Tank - Erect - Access Tube / Platform
LS
1.0
$22,500.00
$22,500.00
$22,500.00
$0.00
$22,500.00
100.00%
$0.00
$0.00
82
M.16 Steel Tank - Erect - Hoist
LS
1.0
$29,500.00
$29,500.00
$29,500.00
$0.00
$29.500.00
100.00%
$0.00
$0.00
83
M.17 Steel Tank - Erect - Floor
LS
1.0
$6,300.00
$6,300.00
$6,300.00
$0.00
$6.300.00
100.00%
$0.00
$0.00
84
M.18 Steel Tank - Erect - Roof
LS
1.0
$18,500.00
$18.500.00
$18,500.00
$0.00
$18,500.00
100.00%
$0.00
$0.00
85
M.19 Steel Tank - Field Coating - Ground Phase
LS
1.0
$202,000.00
$202,000.00
$202,000.00
$0.00
$202,000.00
100.00%
$0.00
$0.00
86
M.20 Steel Tank - Field Coating - Air Phase
LS
1.0
$120,000.00
$120,000.00
$120,000.00
$0.00
$120,000.00
100.00%
$0.00
$0.00
87
M.21 Slab on Grade
LS
1.0
$7,500.00
$7,500.00
$7.500.00
$0.00
$7,500.00
100.00%
$0.00
$0.00
88
M.22 Mechanical - Pedestal - Riser Piping
LS
1.0
$96,000.00
$96.000.00
$96,000.00
$0.00
$96,000.00
100.00%
$0.00
$0.00
89
M.23 Mechanical - Steel Tank - Riser
LS
1.0
$6,800.00
$6,800.00
$6,800.00
$0.00
$6,800.00
100.00%1
$0.00
$0.00
90
M.24 Mechanical - Foundation - Base Pipe
LS
1.0
$34,500.00
$34,500.00
$34,500.00
$0.00
$34,500.00
100.00%
$0.00
$0.00
91
M.25 Mechanical - Chamber - Valves / Piping
LS
1.0
$85,000.00
$85,000.00
$85.000.00
$0.00
$85,000.00
100.00%
$0.00
$0.00
92
M.26 Clearing and Grubbing
LS
1.0
$9,500.00
$9,500.00
$9,499.85
$0.15
$9,500.00
100.00%
$0.00
$0.00
93
M.27 Site Preparation and Grading
LS
1.0
$8,500.00
$8,500.00
$8,499.70
$0.30
$8,500.00
100.00%
$0.00
$0.00
94
M.28 Construction Project Sign
EA
2.0
$2,500.00
$5,000.00
$5,000.00
$0.00
$5,000.00
100.00%
$0.00
$0.00
95
M.29 Hydromulch Seed
LS
1.0
$2,075.00
$2,075.00
$0.00
$2,075.00
$2,075.00
100.00%
$0.00
$0.00
96
M.30 Storm Water Pollution Plan and Erosion Control
LS
1.0
$7,325.00
$7,325.00
$7,325.00
$0.00
$7,325.00
100.00%
$0.00
$0.00
97
M.31 Construction Entrance
LS
1.0
$15.000.00
$15.000.00
$15,000.00
$0.00
$15,000.00
100.00%
$0.00
$0.00
98
M.32 Construction Temp Fencing
LS
1.0
$8,500.00
$8,500.00
$8,500.00
$0.00
$8,500.00
100.00%
$0.00
$0.00
99
M.33 Traffic Control
LS
1.0
$7,500.00
$7,500.00
$7,500.00
$0.00
$7.500.00
100.00%
$0.00
$0.00
100
M.34 Remove Existing Rock and Debris
LS
1.0
$2,500.00
$2,500.00
$2,500.00
$0.00
$2,500.00
100.00%
$0.00
$0.00
101
M.35 Commisioning &Startup
LS
1.0
$2.500.00
$2,500.00
$2,500.00
$0.00
$2,500.00
100.00%
$0.00
$0.00
102
MA.01.1 Site Electrical
LS
1.0
$35,000.00
$35,000.00
$35,000.00
$0.00
$35,000.00
100.00%
$0.00
$0.00
103
MA.01.2 Foundation Electrical
LS
1.0
$50,000.00
$50,000.00
$50,000.00
$0.00
$50,000.00
100.00%
$0.00
$0.00
104
MA.01.3 Pedestal Electrical
LS
1.0
$75,000.00
$75,000.00
$75,000.00
$0.00
$75.000.00
100.00%1
$0.00
$0.00
105
MA.01.4 Tank Electrical
LS
1.0
$40,000.00
$40.000.00
$40,000.00
$0.00
$40,000.00
100.00%
$0.00
$0.00
106
MA.01.5 SCADA Electrical
LS
1.0
$50,000.00
$50,000.00
$50,000.00
$0.00
$50,000.00
100.00%
$0.00
$0.00
107
MA.02.1 Panels
LS
1.0
$35,000.00
$35,000.00
$35,000.00
$0.00
$35,000.00
100.00%
$0.00
$0.00
108
MA.02.2 Chlorine Analyzer and PLC
LS
1.0
$25.000.00
$25.000.00
$25,000.00
$0.00
$25,000.00
100.00%
$0.00
$0. 00
109
MA.02.3 RTU, Wiring
LS
1.0
$40,000.00
$40,000.00
$40,000.00
$0.00
$40,000.00
100.00%
$0.00
$0.00
110
MA.03 Tank Mixing System
LS
1.0
$45,000.00
$45,000.00
$45,000.00
$0.00
$45.000.00
100.00%
$0.00
$0.00
111
MA.04 Site Clearing, Grubbin and Earthwork
LS
1.0
$50,000.00
$50,000.00
$50.000.00
$0.00
$50,000.00
100.00%
$0.00
$0.00
112
MA.05 Split Face CMU Fencing
LF
773.0
$220.00
$170,060.00
$170,060.00
$0.00
$170,060.00
100.00%
$0.00
$0.00
113
MA.06 8 Concrete Paving"
SY 1
370.0
$90.00
$33,300.00
$33,300.00
$0.00
$33,300.00
100.00%
$0.00
$0.00
✓VVV/vILIY I ✓L I/"11L JI ILC I
Hage 5 of 5
A
B
C
D E
G
H
I
ITEM
SCHEDULED VALUE
WORK COMPLETED
BALANCE TO
NO.
DESCRIPTION OF WORK
TOTAL %
COMPLETE COMPLETE
FINISH
RETAINAGE
UNIT
OTY
UNIT PRICE
VALUE
PRIOR
THIS PERIOD
APPLICATION
(C - G)
114
MAX Concrete Swale
LS
1.0
$5,000.00
$5,000.00
$5,000.00
$0.00
$5,000.00
100.00%
$0.00
$0.00
115
MA.08 20 Water Line"
LF
96.0
$800.00
$76.800.00
$76,800.00
$0.00
$76.800.00
100.00%
$0.00
$0.00
116
MA.09 Connection to Existing 24 Water Line"
LS
1.0
$20,000.00
$20,000.00
$20,000.00
$0.00
$20,000.00
100.00%
$0.00
$0.00
117
MA.10 20 Butterfly Valve"
LS
1.0
$20,000.00
$20.000.00
$20,000.00
$0.00
$20,000.00
100.00%
$0.00
$0.00
118
MA. 11 4 Sewer Line"
LF
82.0
$100.00
$8,200.00
$8,200.00
$0.00
$8,200.00
100.00%
$0.00
$0.00
119
MA.12 Trench Safety
LF
370.0
$5.00
$1,850.00
$1,850.00
$0.00
$1,850.00
100.00%
$0.00
$0.00
120
MA.13 SWPPP
LS
1.0
$5,000.00
$5,000.00
$5,000.00
$0.00
$5,000.00
100.00%
$0.00
$0.00
121
MA.14 Mobilization (3% of base bid)
LS
1.0
$44,790.00
$44,790.00
$44,790.00
$0.00
$44,790.00
100.00%
$0.00
$0.00
122
M13.01 Security Improvements
LS
1.0
$65,000.00
$65,000.00
$65,000.00
$0.00
$65,000.00
100.00%
$0.00
$0.00
123
MC.01 Interior Spiral Staircase
LS
1.0
$100.000.00
$100.000.00
$100,000.00
$0.00
$100,000.00
100.00%
$0.00
$0.00
124
MD.01 Increase Head Range to 45'
LS
1.0
$(72,300.00)
$(72,300.00)
$(72,300.00)
$0.00
$(72,300.00)
100.00%
$0.00
$0.00
125
MD.02 Remove Cross -Over Ladder
LS
1.0
$(5,875.00)
$(5,875.00)
$(5,875.00)
$0.00
$(5,875.00)
100.00%
$0.00
$0.00
126
MD.03 Reduce Sample Piping to one Line
LS
1.0
$(5,150.00)
$(5,150.00)
$(5,150.00)
$0.00
$(5,150.00)
100.00%
$0.00
$0.00
127
MD.04 Remove Floor Drains, Except at CL2 Analyzer
LS
1.0
$(4,500.00)
$(4,500.00)
$(4,500.00)
$0.00
$(4,500.00)
100.00%
$0.00
$0.00
128
MD.05 Replace AST Vent with Newlms Vent
LS
1.0
$(3,750.00)
$(3,750.00)
$(3,750.00)
$0.00
$(3,750.00)
100.00%
$0.00
$0.00
129
Reduce Upper Landing to Half Span, Elimminate
Second
Second Upper Pedestal Louver
LS
1.0
$(8,875.00)
$(8,875.00)
$(8,875.00)
$0.00
$(8,875.00)
100.00%
$0.00
$0.00
130
MD.07 Delete Anti -Graffiti Coating
LS
1.0
$(8,250.00)
$(8,250.00)
$(8,250.00)
$0.00
$(8,250.00)
1 00-000%$0.00
$0.00
131
MD.08 Delete Settlement Monitoring
LS
1.0
$(4,500.00)
$(4,500.00)
$(4,500.00)
$0.00
$(4,500.00)
100.00%
$0.00
$0.00
TOTALS:
$10,640,600.00
$10,632,904.55
$7,695.451
$10,640,600.00
100.00%1
$0.00
$0.00
A
B
C
D E
G
H I
ITEM
SCHEDULED VALUE
WORK COMPLETED
NO.
DESCRIPTION OF WORK
TOTAL
%
BALANCE TO
UNIT
CITY
PRICE
VALUE
PRIOR
THIS PERIOD
COMPLETE
COMPLETE
FINISH RETAINAGE
(C G)
APPLICATION
-
132
1 PCCO#001 Reconciliation Change Order
4.0
$254,783.45
$(82,755.30)
$0.00
$(82,755.30)
$(82,755.30)
100.00%1
$0.01
$0.0
TOTALS: 1
$(82,755.30)
$0.00
$(82,755.30)
$(82,755.30)
100.00%1
$0.00
$0.00
Grand Totals
A
B
C
D
I E
G
H
I
ITEM
NO. DESCRIPTION OF WORK
SCHEDULED VALUE
WORK COMPLETED
TOTAL
o
BALANCE TO
COMPLETE
COMPLETE
FINISH
RETAINAGE
PRIOR
APPLICATION
THIS PERIOD
(C - G)
GRAND TOTALS:
$10,557,844.70
$10,632,904.55
$(75,059.85)
$10,557,844.70
100.00%
$0.001
$0.00
Docusign Envelope ID: 506F4165-6580-4F93-972F-822CEB60D7D4
Consent of Surety to Final
Payment, Affidavit of Release of
Liens, and Affidavit of
Payments of Debts and Claims
DocuSign Envelope ID: 506F4165-65804F93-972F-822CEB6OD7D4
Consent of
to Final
RFP 20-14949-TF 50th Street and Milwaukee Avenue 2.0 MG
Project Elevated Storage Tanks
Owner City of Lubbock
Contractor Landmark Structures I, L.P.
Construction Manager Freese and Nichols, Inc.
Design Professional Ryan Opgenorth, P.E.
Project
Contract Price $ 10,557,844.70 Effective Date of the Contract April 14, 2020
Bond Amount $ 10,640,600.00 Date of Bond April 14, 2020
i Contractor as Principal
Name Landmark Structures I, L.P
Address 1665 Harmon Rd.
Fort Worth, TX 76177
Surety
Project Number
92452.9241.30000 j
1683 & 1684
Name Fidelity and Deposit Company of Maryland
Address 3910 Keswick Road
Baltimore, MD 21211
Surety approves final payment to the Contractor in accordance with the Contract Documents. Surety agrees that
final payment to the Contractor does not relieve Surety of any of its obligations to the Owner under the terms of the
----% Contract.
Signature
Name
' Robyn Rost
Title
Attorney -In -Fact
Date
September 22, 2022
Phone
732-335-5342
Email
robyn.rost@usi.com
(Attach Power of Attorney)
Consent of Surety to Final Payment Page 1 of 1
Uocusign Envelope ID: 506F4165-6580-4F93-972F-822CEB60D7D4
ZURICH AMERICAN INSURANCE COMPANY
COLONIAL AMERICAN CASUALTY AND SURETY COMPANY
FIDELITY AND DEPOSIT COMPANY OF MARYLAND
POWER OF ATTORNEY
KNOW ALL MEN BY THESE PRESENTS: That the ZURICH AMERICAN INSURANCE COMPANY, a corporation of the State of New
York, the COLONIAL AMERICAN CASUALTY AND SURETY COMPANY, a corporation of the State of Illinois, and the FIDELITY AND
DEPOSIT COMPANY OF MARYLAND a corporation of the State of Illinois (herein collectively called the "Companies'), by Robert D.
Murray, Vice President, in pursuance of authority granted by Article V, Section 8, of the By -Laws of said Companies, which are set forth on
the reverse side hereof and are hereby certified to be in full force and effect on the date hereof'; do hereby nominate, constitute, and appoint ,
Robyn ROST and Raymond GIL, both of Matawan, New Jersey, EACH, its true and lawful agent and Attorney -in -Fact, to make,
execute, seal and deliver, for, and on its behalf as surety, and as its act and deed: any and all bonds and undertakings, and the execution of
such bonds or undertakings in pursuance of these presents, shall be as binding upon said Companies, as fully and amply, to all intents and purposes,
as if they had been duly executed and acknowledged by the regularly elected officers of the ZURICH AMERICAN INSURANCE COMPANY at
its office in New York, New York., the regularly elected officers of the COLONIAL AMERICAN CASUALTY AND SURETY COMPANY at
its office in Owings Mills, Maryland., and the regularly elected officers of the FIDELITY AND DEPOSIT COMPANY OF MARYLAND at its
office in Owings Mills, Maryland., in their own proper persons.
The said Vice President does hereby certify that the extract set forth on the reverse side hereof is a true copy of Article V, Section 8, of
the By -Laws of said Companies, and is now in force.
IN WITNESS WHEREOF, the said Vice -President has hereunto subscribed his/her names and affixed the Corporate Seals of the said
ZURICH AMERICAN INSURANCE COMPANY, COLONIAL AMERICAN CASUALTY AND SURETY COMPANY, and
FIDELITY AND DEPOSIT COMPANY OF MARYLAND, this 26th day of September, A.D. 2019.
y a ocroj�
two
BRA
ZURICH AMERICAN INSURANCE COMPANY
COLONIAL AMERICAN CASUALTY AND SURETY COMPANY
FIDELITY AND DEPOSIT COMPANY OF MARYLAND
By. Robert D. Murray
Vice President
SDCIAV�L 4 14AWBG
By. Dawn E. Brown
Secretary
State of Maryland
County of Baltimore
On this 26th day of September, 2019, before the subscriber, a Notary Public of the State of Maryland, duly commissioned and qualified, Robert D.
Murray, Vice President and Dawn E. Brown, Secretary of the Companies, to me personally known to be the individuals and officers described in and who
executed the preceding instrument, and acknowledged the execution of same, and being by me duly sworn, deposeth and saith, that he/she is the said officer of
the Company aforesaid, and that the seals affixed to the preceding instrument are the Corporate Seals of said Companies, and that the said Corporate Seals and
the signature as such officer were duly affixed and subscribed to the said instrument by the authority and direction of the said Corporations.
IN TESTIMONY WHEREOF, I have hereunto set my hand and affixed my Official Seal the day and year first above written.
;r
Constance A. Dunn, Notary Public
.p►)4�,�;:�
My Commission Expires: July 9, 2023
uocuSign Envelope ID: 506F4165-6580-4F93-972F-822CEB6OD7D4
EXTRACT FROM BY-LAWS OF THE COMPANIES
"Article V. Section 8, Attomevs-in-Fact. The Chief Executive Officer, the President, or any Executive Vice President or Vice President
may, by written instrument under the attested corporate seal, appoint attomeys-in-fact with authority to execute bonds, policies,
recognizances, stipulations, undertakings, or other like instruments on behalf of the Company, and may authorize any officer or any such
attorney -in -fact to affix the corporate seal thereto; and may with or without cause modify of revoke any such appointment or authority at any
time."
CERTIFICATE
I, the undersigned, Vice President of the ZURICH AMERICAN INSURANCE COMPANY, the COLONIAL AMERICAN
CASUALTY AND SURETY COMPANY, and the FIDELITY AND DEPOSIT COMPANY OF MARYLAND, do hereby certify that the
foregoing Power of Attorney is still in full force and effect on the date of this certificate; and I do further certify that Article V, Section 8, of
the By -Laws of the Companies is still in force.
This Power of Attorney and Certificate may be signed by facsimile under and by authority of the following resolution of the Board of
Directors of the ZURICH AMERICAN INSURANCE COMPANY at a meeting duly called and held on the 15th day of December 1998.
RESOLVED: "That the signature of the President or a Vice President and the attesting signature of a Secretary or an Assistant Secretary
and the Seal of the Company may be affixed by facsimile on any Power of Attorney ... Any such Power or any certificate thereof bearing such
facsimile signature and seal shall be valid and binding on the Company."
This Power of Attorney and Certificate may be signed by facsimile under and by authority of the following resolution of the Board of
Directors of the COLONIAL AMERICAN CASUALTY AND SURETY COMPANY at a meeting duly called and held on the 5th day of May,
1994, and the following resolution of the Board of Directors of the FIDELITY AND DEPOSIT COMPANY OF MARYLAND at a meeting
duly called and held on the 1 Oth day of May, 1990.
RESOLVED: "That the facsimile or mechanically reproduced seat of the company and facsimile or mechanically reproduced signature
of any Vice -President, Secretary, or Assistant Secretary of the Company, whether made heretofore or hereafter, wherever appearing upon a
certified copy of any power of attorney issued by the Company, shall be valid and binding upon the Company with the same force and effect
as though manually affixed.
IN TESTIMONY WHEREOF, I have hereunto subscribed my name and affixed the corporate seals of the said Companies,
this 29th day of September , 2022 .
SAL
_ o
soap ��
Mww r
Brian M. Hodges. Vice President
TO REPORT A CLAIM WITH REGARD TO A SURETY BOND, PLEASE SUBMIT A COMPLETE DESCRIPTION
OF THE CLAIM INCLUDING THE PRINCIPAL ON THE BOND, THE BOND NUMBER, AND YOUR CONTACT
INFORMATION TO:
Zurich Surety Claims
1299 Zurich Way Schaumburg, IL
60196-1056
www.reports Mai.ms(a zurichna.com
800-6264577
vocu,wgn r-nveiope iu:5Ubr41bb-bbt3U-4"3-9/LF-b2ZCEB60D7D4
THE FIDELITY AND DEPOSIT COMPANY
OF MARYLAND
1299 Zurich Way Schaumburg, IL 60196
Statement of Financial Condition
As Of December 31, 2021
ASSETS
Bonds............................................................... $ 237,467,504
.....................................
Stocks................................................................................................................................. 18467
,985,762
....4
Cash and Short -Term Investments .......................................
Reinsurance Recoverable ............................................................................... 7,415,852
Federal Income Tax Recoverable
......................................................................................... 25,735,324
overable..................................................................................................... 0
OtherAccounts Receivable...................................................................................... 24,479,233
...................
TOTAL ADMIT E-D ASs Ts ..................................... ............. $ 314,083,675
LIABILITIES, SURPLUS AND OTHER FUNDS
Reserve for Taxes and Expenses.......................................................... .
Ceded Reinsurance Premiums Payable................................................................................... ......... 48,876,599
Remittances and Items Unallocated .............................
Payable to parents, subs and affiliates ......................................
Securities Lending Collateral Liability........................................................ 0
TOTAL LIA13ILMES ................................................................
Capital Stock, Paid U..........................................5,000,000
................................................ . $ 49,254,700
Surplus......................p................................................................................... $ .......
................................................... 264:828,975
Surplusas regards Policyholders................................................................... 264,828,975
TOTAL
.......................................................................................................... $ 314,083,675
Securities carried at $78,561,855 in the above statement are deposited with various states as required by law.
Securities carried on the basis prescribed by the National Association of Insurance Commissioners. On the basis of
market quotations for all bonds and stocks owned, the Company's total admitted assets at December 31, 2021 would
be $319,561,762 and surplus as regards policyholders $270,307,062.
1, LAURA J. LAZARCZYK, Corporate Secretary of the FIDELITY AND DEPOSIT COMPANY OF MARYLAND, do
hereby certify that the foregoing statement is a correct exhibit of the assets and liabilities of the said Company on the
31 st day of December, 2021.
DoeuSigned by:
(AWO-A• taA"k
Corpomle Secrelmy
State of Illinois
City of Schaumburg SS:
Subscribed and swom to, before me, a Notary Public orthe State of Illinois, in the City of Schaumburg, this 15' day of March, 2022
=-
��Ntolatr�AN
al
e of Illtnols Nora)y Public
Dee 10, 2024
DocuSign Envelope ID: 506F4165-6580-4F93-972F-822CEB60D7D4
Affidavit of Ralaaca of I ionc
RFP 20-14949-TF 50th Street and Milwaukee Avenue 2.0 MG
Project Elevated Storage Tanks Project Number
Owner City of Lubbock 92452.9241.30000
Contractor Landmark Structures I, L.P. 1683 & 1684
Construction Manager Freese and Nichols, Inc.
Design Professional Ryan Opgenorth, P.E.
Contractor, in accordance with the Contract Documents, and in consideration for the full and final payment to
Contractor for all services regarding the Project, does hereby waive and release any and all liens, or any and all
claims to liens which it 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. 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 Contractor prior to, through, and including the date of this affidavit.
Exceptions
If none, write "None." Contractor must furnish a bond, acceptable to the Owner, for each exception.
None
By
(signature)
Date September 29, 2022
(date signed)
Name Keri Adrian -Williams
(typed or printed)
Title Vice President of Finance & Accounting
(typed or printed)
Representing Landmark Structures I, L.P.
(typed or printed)
Notary Attest
Sworn to (or affirmed) and subscribed before on 9/29/2022
(month, day, year)
Personally Known Produced Identification, Type and No. of ID
By - << 4
(notary's signature)
Name Emily Mayfield
(typed or printed)
BMiLY MAYF18l.D
Notary Public - State of Texas Now PublK Sum of Tltota
(typed or printed) CMm. 0"1-4
t ID Isill odeo
My commission expires April 21, 2024
(expiration date) (Notary Seal)
Affidavit of Release of Liens Page 1 of 1
uocuNgn tnvelope IU: 5U6F4165-6580-4F93-972F-822CEB60D7D4
Affidavit of D2umanfe of nakfc �_A riI ,_
RFP 20-14949-TF 50th Street and Milwaukee Avenue 2.0 MG
Project Elevated Storage Tanks Project Number
Owner City of Lubbock 92452.9241.30000
Contractor Landmark Structures I, L.P. 1683 & 1684
Construction Manager Freese and Nichols, Inc.
Design Professional Ryan Opgenorth, P.E.
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 Contractor for damages arising in any manner in connection with the performance
of the Contract referenced above for which Owner or its 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. " Contractor must furnish a bond, acceptable to the Owner, for each exception.
None
By
(signature)
Date September 29, 2022
(date signed)
Name Keri Adrian -Williams
(typed or printed)
Title Vice President of Finance & Accounting
(typed or printed)
Representing Landmark Structures I, L.P.
(typed or printed)
Notary Attest
Sworn to (or affirmed) and subscribed before on 9/29/2022
(month, day, year)
Personally Known Produced Identification, Type and No. of ID
By�
(notary's signature)
Name Emily Mayfield
(typed or printed) EMILY MAYFIELD
Notary Public - State of Texas No" Pub8o, 8fa»of TI
(typed or printed) co m. 04414M
NotesiID 12501U19
My commission expires April 21, 2024
(expiration date) (Notary Seal)
Affidavit of Payments of Debts and Claims Page 1 of 1