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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) o EXISTING EOLECTRICAL PAD O JG 20' O \ PROPOSED 5' I CONCRETE SIDEWALK ES7'1- BX `® EST1-01 PBX FRY ADDITION \ EX TANK SUPPORT Vol. 1671 Pg. 44 \ FOUNDATIONS ' (REMOVED TO 10' I O BELOW GRADE IN I I DEMOLITION I I CONTRACT) � �JBE►❑JBE � CENTER OF TANK \ N 7263230.43 E 935994.50 T-9) - 3" WASHOUT LINE �EST1-02 PROPOSED D ELEVATED 20 WATER TANK LINE REMOVE AND SALVAGE EXISTIN ED CONCRETE PEDESTAL ' 1 EXISTING ALTITUDE FIRE HYDRANT VAI \/F \/A[ 11 T P Ln N N /1 PROPOSED FENCE (RE: 7/ DT-4) REMOVE EXIST)NG CONCRETE CURB 0 M rq a M 0 rq W 0 0 z a W D M 0 N O I� LL � V 211 203 110 0 _J LJ.. `-- R5' 215 _ I I I CO R5' o N, � 204 \® EST1-01 LOT 17 \ FRY ADDITION r \ \ 105 I I ❑ I Q I F.F L. 3252.70 306 'EST1-02 0 U— O C)P 107 s 0 m a ko 0 rq 0 W 0 0 z Q W D D 0 N LOT 1-A-1 FRY ADDITION Vol. 10376 Pg. 130 --------------- i I 1G Y U L LI f'- 0 Z ,z co w 2 > w N Q > Z LLI Q o w a Lu J Y F— L ::D LA 1 n Q L > z -- 0 C U V IILI1 1 %.%JIVlri PEDESTAL MOi PROVIDE THE I MOUNTED ME 2. PROVIDE WALI BOTTOM OF TI 3. GROUND MAT 4. CONDUIT, FIBE RIGHT -OF -WA` 5. PROVIDE 2 #1C 6. PROVIDE 1" CC LOCATION OF 1 CABLE FOR PTd PROVIDED BY " 7. ROUTE CELLUL DRIVEWAY. RC DUCT BANK M DESIGNATE TH 8. PROVIDE TWO PROVIDE FIBEF FIBER TERMIN, ❑3 -� i N400� 9. PROVIDE 24" X 10. PULL BOX PRO Eci 1 M 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