Lnterm diate and finaI eleaning for Work not including special ...

01 74 23 - 1

CT. EANING

Page 1 a.f4

SECTION Ol 74 23

CLEANING

PART 1 GENE12A7,

l.l. SUMMARY

A, Section Includes:

Lnterm diate and finaI eleaning for Work not including special cleaning of closedsystems specified elsewhere

B. P r atic, ns i axaz this i y of art Wortaa Standard Specificati il

1+ r e.

arPrl CCI 1G ilOi7 ..: Y_i nc ICIGIUC' C_ hri# arP nnt p CeSS31' l j+ ICCYItEL{' dl;

1. L7 i isian LI - b i! tl+r,g IE equirements, C.onnaci F'orr s ; 3n ' ditians r±i' thP c' n#r- rt

L} i' Sinii I - C; r al Uuc uirements

3. S ction 3? ' 2. 4 -; yrir- f: ichm, + eeding and Sudding

f" iC. ANlb l; a f n T',N' i' 1 I OC:,EIIiJk l+ S

Jj, j; t{ Si rPm nl. 2ii f ' i 1Tl 17

1- ( 1r1{ c{ 3. jatr ur?rh 111s jieyi7 IS Ct r cir{;.rr.ri St1 7Si(!:`! rY t(] L l V l"I ti14 lI!?? S L ii.l.

Nn ; P arate , yt ent =: il be rE» ved far ii is It m.

i.3 L F,T+'1'., NCES ' N T i1 Fri l

j.- A 1! 1 Y''' Nis` iTi-l M f' 1''

1, . hedulTn

1_ ;: he+ isile c; 1 nin n eratiarrs latiat t, as , rGci h r onx; arrtir ants ri» rhpCj fy•

aanin, I roc ss c. ill i a 1 ^ n ne Wfy pain ed urfaces. Ch,! e 4ira1 cipanL7L 11Q:? n cmm{_ e.ti q nt : xJo:' Ji I??" 1C1 14 SI] 1 CI1 1 J t r o iit i

II Y? r: iUF

1 .` t i ii' I'}. {' Tf' a.+ i

I.. i A' Tir?N S[]? 1v TT` i; SII 1.'+ R.1V A'FI[ 1 i 4I fiYTRIy fTT; i# NC1T Ci+'!}

7 C°.', Ct 7T1%1 1 T'': f.. O T Y7 1 I

l. LA#' 1` lA;] C"; P' L L' i' R 1i Ip'[ 1T' E'. i C'' II H` 7

9 QCJAL. TI' AaSll? l+IVC' F N{]" ii` lJSED I

1 T(] I AC-?+, ,41 TL .. J DLiN{;

r', 1' F C' '. i21( 1ant iln 4 lkiC. mPnfy

1. S? orP cleaning prc ei tc s and i;l anin wastes ir n±3iners speciLical l} e; ned for

ioge r,are ial .

Cffl' r I; rf- I R' G'RT!-! CCh4o; s a uf i4iL k` J, ill:,s w i'!' I:* mrovement I AN[ l,q?»'.),•- rulJl' E' l rd tiNF!' f4lC Tf4] N f3f1r] rvr. r I? d3 t

4tev sed •! v I. 1( i 1

O1 74 23 - 2

CLEAI+ IING

Page 2 of 4

1. 1I FYELD [ SITE] COND TIONS [ NOT USED]

1. 1 WAlt1 ANTY jNOT USED]

PART 2 - PRODUCTS

Z. 1 OWNER FIIRNISHED [ au] OWNER- SUPPLTEDPRODUCTS [ NOT iTSED]

2. MATERIAL

A. Cleazzzng Agents

1. Compatible with surface be ng cleaned2. New and uncoiitaminated

3. Far manufactured surfaces

a. Mates•ial recommendad by rx.anufact u•ar

3 ACCESS RIES [ NOT USED]

4 SOi7RCE QUALITY CONTROL [ NOT USEDI

PART 3 - EXECUTION

3. 1 IN5TALLERS [ NOT USED7

3. ti E ANIINATION jN T USED]

3. 3 PREPARATION [ NOT USED]

3. 4 APPLICATION [ NOT IISED]

3, 5 R PAIR I RESTORATYON jN T iTSEDj

3. 6 RE- INSTALLATIQN [!\ 7'' USED]

3. 7 FIELID [ axJ ITE QL; ALITY CONTRO [ NOT USED]

3. 8 SY TEM STARTUP [NOT USED]

3. 9 ADJUSTING [ NOT USED]

3, 3. G LEAlVINf

A, Grener!

1, I revani accr. ulation of wastes that create hazardous conditions.

J: Conduci: eleaning and disposal aperatzons to comply with laws and safety orders ofgoverning autharit es.

3. Do i at dispose of volatile wastes such as rnineraI spirits, oil ar paz t thznner instorm or sanitary drains or sewers.

4. Dispose af degradable debris at an approved solid wasie disposal site.

5. Dispose of nondegradable debris at an appro ed solid wa te disposal site or in an

alterna e manner approved by City arzd regulatoiy agencies.

rry r. r OR"I W R rri r.G M: s nd ML Phillips SRTS Improvements

51' AN Ai2D CO?+STR I. l; Tln} J pEC'? FtC,I+''Inla T7CL UIvIEI T' r. CPN 102411

Revised 7ulv , !?! j

Q17423- 3

CLEANiNG

Page 3 of 4

6. Handle rnaterials in a controlled manner with as few ha.ndlings as possible. 7. Thoroughly clean, sweep, wash and polish all Work and equipment associated with

this pro ec't.

S. Remove all signs oFtempnrary construction and activities i aci iental to aonsttuctianaf requirred pennanent Wark.

9. If project is not cleaned to the satisfactior nf the City, the City reser ves the right taave the cIeaning compieted at the expense af the Contractor.

10. Do not burn on- site.

B. Intermediate Cleaning during Construction1. Keep Work areas clean sa as nat to hinder health, safety or can enience of

persannel in ex. sting facility operaiions. 2. At m innun weekiy intervals, dispose of waste zn:ateri ls, debris az d rubbish. 3. Con ine consiructior debris daily in strategically located container( s):

a_ ' nver to prevent blowiug by windh. t re hris away l om coustruction ar operatiaria acciviiies

uE i-n 7 s; rP st a mknimum of once pe,- w ekti1, , a uurn cYeau Qnterioa• ureas ye ready i.o s eceive iii ish paiilting.

u_ C.c.nti3 ue va uum c anYng ar n us- i eedecf I) a ir,, i iy1 i C Pina Acc; ptance_ 4" rior i s± rm e ti nts, thororaghly cieam ; te of all loose n* • P_ y, r d items, xlh; ch

n ay [nNvc r, airhar7 e r r transn rted bv flowing water during t e s*., m,,

prerin3 } jnal (', 4 anin

1_ ?: m ve rreas, .. stic, , cYhesives, usf,_ dir. si ins, fngerprints, lah s t ci ot aer

Forei n materials rom si ht- ex osed : ta rf c. s_

11j] E:,: in iiClUt" e "[: i CTOY,g, pnc c, ynnS 3i1 t1Tl;S• a,

3. h antl. s 1 ne glaLing rind rni rurs. 4, Po€ i? la 5y rfaces te c e r h4i-

V ntilating t>+ s#: tt sri, l'; an ermanent f ltera 4nii repi. ce r]ispt 5 b1 fitters if units vvere operated

C{ Ui':! c Ci1{ ZCtt' 4( lictil'1. b, C lean ducts, bin T};- s nd cniis Ft` ? tsts r r re nperated without ilters durimg

C{? fl rn tinn,

i e 1 ciG l rn? 4lki : 3TI1113S.

fi

E' nnr 1 i S a!' l IThJ4 xJ. 1 i5 4' f ` J} iS,

I49c p af. n! cn+a rn] r: r n} l o r,

D. :.,,;„- { i r I{ i ht. f 1 Y': y ' i 7 (.' Jc : r i 7g

rnav t h a! d ris c nta ners I ot aite.

p- szed ar c T bed bv locatio.n f Irash and dehris c;:? ntau ers is aC«. rdAnce

e irrh Sw? ic,: = t2'? f 3,

7 ]"; a{ 4 1I I{ 3 L;/" 1\ iP YC c'. l: S, } igrPS C} f k5 13ft{ CCi iri Pt [) 1' c!]+ 0 1' 0 18Cj

H :; Tll : Y 1n,r.,ie; r{ tii- tllsrLtR 1 Ti]? t r?W Oj T[' r I IC i1 VQt?'', . 1 1'{;::; itxra', -

zt1kY nV ii ferjt r dI'Cas : l7G lc in, 4 u r a? Gmir k, V UIiQ, Ill. n.}±ni? y, : tl' llti Cur s,

iunotiun ? oxe ? jnlets.

t'. P1' 4 1F 1 41] t l ';! F? fei CC' hQ[? SS d ld F•?.. 1'] 1: 1li,++ SR' I' C1[ kir;^++rinente

7 h; PA,FLE7. uNSTRL' c, T1Gti' Hr4FlC;! 7- lONi? C] t_; fEN' fs i"}N Ifl? li

hevisad July 1, 2011

017423- 4

CLEAN] NCr

Page 4 of 4

4. If na longer required for ma ntenance of erosion facilitaes, and upon app• ovaI byCity, remove eroszon control from site,

5. Clean signs, lights, signals, etc.

3. 11 CLOSEOUT ACTIVIT7ES [ NOT USED]

3. 1 PROTECTI N [ NOT iTSED]

3. 3 MAINTENANCE jNOT USED]

3.14 ATTAC:FiMENTS [ NOT USED]

END OF SECTION

Revisian L g

DATE NAME SUMMARI OF CHANGE

CITY OF FORT WORTH CG Mass and ML Phillips SR"TS IniprpVements

STI ISDARD CONSTRUC3' IUN SYI3CTF1Cr' r?;}?V D;] C U 4E: Y" i5 CPN 102411

Ravised 7ulv 1, 2Qt i

O1 77 19 - 1CLflSEflUT REQUIREIvIENTS

Yyee lof3

2

3 PA RT l - GENIItAL

1. 1 SU1Vfl17ARY

sFCTTorr oi 77 9

CLOSEO[]' T REQUIREMENTS

5 A, Sectzon Includes:

6 1. The proaedure for elosing ut contract

7 B. Deviations from this City of Fort Worth Standard Specificatian8 I. None.

3 C. ReIated Specif'tcatiaza Sections include, but are not necessarily limited i: lt? 1. Division 0— Bidding Reguirements. Contract Forms and Conditions u' ihe or;lra- x11 2. Division 1— General Requ rement

12 !. ' PR.ICE e" T ' AYl v' NT R() t' D1[ J1if±;5

13 , hriea" T,,, nt anc P y: e: t14 I. ' Jurk assuciated with this item is c. rnsider d suhsiciiary ta xtre yT,riaus I e ms E3i l, 15 I` arw: p nayment v rill he allnwed for this Item. ib . i Fr+.Rr vc; . isnT a, l

17 A.. A l'VIIMSTRAI VE REC UIRIIYIII iq'S

8 , 1, Cr r:!-! t s. +. s ar.d 11i' 3 W ::: s

7 l. [ 4 appl. ation r iinal payment x;>; I be acceptec! umil afl u ar it es, bonds, rtificaf_.es, licenses and ai-?= v; tc r uitred for Work or eguinment a.s s` eeified are

ati} faciuri7y t! i ' r:: I City,

el.ease aof Is ens c i- C mS

U innlicaL o I'} 1` ' 1!? wl lAVTI" E{:; lj V* J Iki i} rC 7teCI Llntil rariSt'.: C{ Y'} 1' k t:3C C} f

2+.; , r iPaS ' ii r, ati [ y n ihmitied to i1e { ty.

25 .. 1. i3ti TTAL i

l_S 1

f

2#

y

k}

33

32

ll°17ii7. t ;' f£ llll' i { C! G4YI:: untati^: 1 fl P' S fi7 Cf Y 1' PCP7' YT147Y1 7P

1. 5 ' JRM.' I CkN. L 4L!. rr'!" li L-S [; 4T Ll;;!

i. 7 ; f)CF.f jIT 1` I' I'A'L li`' LTSFi)

RT ? - Ft T)[ iC".,+ ( l' 1' ! . I,'SF: I

r ' C F F RT W OEt: a "(- . l i:: s u d 4L hilii n + t r5 n „ rPr„ F.,n

S'i l} ALti: l.:ak]w4' iR'.f4' fR{ 1? tiY:;`! Hi[.' A-• k; 1N E'wnrrT vi: CS i.};} 14 1

evised March 22, yU21

01 77 19 - 2

CLOSEQUT REQiJIREMENTS

Page 2 of 3

1 PART 3 - EXF.CUTION

2 3. 1 INSTALLERS [ NOT USID]

3 3. EX MiNATION [ NOT iTSED]

4 3. 3 PRII' ARATION [ NOT iJ ID]

5 3. 4 CLOSEOUT PROCIDURE

6 A. Prior to requ sting Final Inspection, suhmit: 7 1. 1' roject Record Documents in accordance vcrith Sectinn O1 78 39

8

9

10

11

12

I3

14

15

16

17

18

19

20

21

22

23

24

25

25

27

28

29

o

31

32

33

34

3S

36

37

2. Operation and Maintenance Data, if required, in accordance with Sec ion O 1 78 23

B. Prior to requesiing Final Inspection, perform iinal cleaning in accordance wrth SectionO1 74 23.

C. Final nspection

1. A,fter fin.al cleaning, pxovide noti e to t ie City Project Representati e that th VVorkis completed.

a. The City will make an initial Final Inspection w h the Contractor presentUpon campletion ofthis nnspectian, the City will notif'y the Cantractor, in

writuag w hin 10 business days, of any particulars ir which this inspectionre eals that ihe Warlt is de% ciive or incomplete.

2. Upon receiving written notice fra.m the City, irnr aedzately undertalce #he Warkrequired to remedy deficiencies and complete the Work to the satisfactian of theCiry.

3. The Right- of-way shall be cleared of all construction materials, barricades, andtemporary signage.

4. Upan completion of Work associated with the items iisted in the City's writ ennotice, uiform the City that the required Work has been compl ted. iJpon Xeceipt ofthis not'rce, the City, in the presence of the Contractar, wi11 niake a subsequ nt FinalInspec.tion of the project.

5. Provide a l special accessories required to place each if:em of quipznent in fullopez-ation. These special accessory items include, but are not lnnited to: a. Speci£ied pare partsb. Adequate oil and grease as required for ihe first lubrication of tha equapzx entc. Initial filI up of all chemical tanks and fual tanksd. Lzght bulbs

e. Fuses

Vault keys

g. Handwheels

h. Other expendable items as required for initial startup and opexatian af allequipment

3 D. Notice ofProject Cornpletion

39 1. nce the Ciky rojecf Representative finds the Warl subsequeni to Final Inspection40 to be satisfactory, the City wi11 issu allotice f Project Completion ( Green Sheet).

4i E. Supportit g Documentatiion

CITY OF FORT WORTH

STANDARD CONSTRUGTION SPECIFICATION DOCUNIENtS

Revised March 22, 2021

CC Mass and ML Fhillips SRTS Improvemants

CPN 102411

O1 7714 - 3

CLOSEOUT REQUhtEMENTS

P e3of3

1

2

3

4

5

6

7

8

9

10

II

17

i3

14

l5

16

17

18

1 t

r

a

22

L:

1. Coordinate with the City Pro ect Representative to camplete th followingaddrtional forms:

a. Final Payment Request

b. Statement of Contract Time

c, Affidavit of Payment and Release ofLie as

d. Consent of Surety to Final Paymente. Pi e Report ( if requieed)

f. Cantractor' s Evaluation of Cityg. Perfarmance Evaluatian of Cantractor

F. Lettei- , f Fina 1 Lcr. t ce

1. Upon. review axad icr_.PptattCe n; Nntir_.P nt ProjeCi l:ot Clp etion a' td ; nr n

U c; mentation, ir ac; o- etancc; wv i±, ; en r l C'on itions, C` ty will i;sue L, tter uli::! l..?• ptance and release the Finaf Pay ent 1? e uest or navment.

5 AYR ! , R' TaRATI01! [ NUT USED]

b + INSTAL1 T10N1 ' 1' T' US]L]

3. 7 lC IIELD lc l' ( JALC7Y N''!? [ YO"I' 4J H]

3. 8 SY; r,+± ':`. r ll r 4?` r Z.,r p.i

s IJUSTING 7' rriSlQyl

3. L L+a N tC3 S: TOT i;

C: L] E() iJI [;" 1 TrF ` I() T C i;bj

3. iPROTF' Tf+D 1 1' rrc

3, 13 11nbTN1 A' [ NO T' . 1

3. e'!' r: iC'.,?'! ' vlCl` E' II)

11 ?:` «' CT7[) N

trv; sinE1

1 r; ,' er r cr n r a zyn rrra7vr:.

7 r nZ 1 M Ouen 3. 4 C. Added lang age # o clarify nd emphasizc , tir uircm+ i tu " C.leari g ROW"

26

C' f Y G': F(} R7 ' ii' O 7' I i

p Ni 3u i y{ rnrc ; rr i ' 1{ 1? y tiPFCIk IC A[ ON I ix M. i M! =-M' G 4

iie s M[arclt , 2021

C-' C' ios: -^.''';". I-!' h; I1: rsS:' f i. sy rnve, 1y

t "4' l' a rndl f

017823- 1

OP RATI03V AND MAII ITENANCE I7ATA

Page i a£ 5

SEC' TION OI 98 23

OPERATION AND MAINTENANCE DATA

PART1- GENERAL

1. 1 SUMMARY

A. Section Includes:

1. Produ t data ai d related infarmation appropriate for City' s maintena lce arzdopera ion af products furnished under Contract

2. Such products may include, but are not limited to: a. Tr c Controllers

b. I•rigation Confi ollers ( to b.e operated by tk e City) c. Butterf y Valves

B. Deviations from this City of Fo t Waxtla Standard Specificationl, Nane.

C. Related Specification Sections include, but are nat necessaeily Ii nited to: 1. Division 0— Bidc#zng Requirements, Contract Foi rns arid Canditions of th.e Contract2. Dir ision 1— General Requuements

1. 2 PRICE AND PAYMENT PR CEDiTRE

A. Measuremeni and Paynnent

1. Wark asso iated with t.kis Item is conside• ed subsidiary to the various Iternns bid. No separate payment will be allow d far this Item,

1. 3 REFERENCES [ NOT USED

1. 4 ADIVIINISTRATNE REQUIREMENTS

A. Schedule

1. Submit manuala cn final farin to the City within 30 calendar days of productshipment to fihe project site. •

1. 5 5i]Bl1'1!' i" ALS

A. Submittals shaII be in accordance with Section Ol 33 00 . All subm.ittals shall be

appro eci. by the City prior to deliveiy.

1.6 INFORIVIATT NAL SUSMITTALS

A. Submittal Form

T. Prepare dafia in orm of an inst• uetinnal nanual for use by City pe• sonnel. 2, Fa• anat

a. Size: S'/ 2 inches x I1 inches

b. aper

1) 40 pound tn.in i nu a, white, for typed pages2) Holes reinforced with plas ic, cloth or metal

c. Text: Manufaciurer' s printed data, or neatly typewritten

CdTY OF FORT WORTH CC Moss a id ML Ptiillips SRTS. improvements

STANDARD CON3TRLTCTIQN SPECIFICATION DOCiTMENTS Cl'N 142411

Revised December 20, 2012

oi sz- z

OPFI2A'I'lON AND MAINT, 7 TFINCE DATA

Page 2 of 5

d

e.

f.

Drawings

1) rovide reinforced punched bindar tab, bind ii witt text2) Reduce largei• drawings and fold to size nFtext pages. Pro ide fly- leaf for each sepaxate product, or each piece of operatingequipment.

1) Pra ide fyped descriptaon ofproduct, and majar coz pan zzt parts ofequipinent.

2) Proeide ind xed tabs.

Co er

1) Identify eacl volume vith typed or print d titIe " OPERATING AND1VIAINTENANCE INSTRUCT QNS".

2) List;

a) Tit1e ofProject

b) Identity of separate structure as applicablec) Ideniity oi general subJect matter eover d in the manuaI

3. Binders

a. Cammerczal quaiity 3- ring binders with durable and c eanable plastic co ersb. When multiple bind rs ar us d, cai7elate the data ' rrito related consisient

graupings,

4. If availabfe, provide an electronic form af the O& 1bI ManuaI.

B. Manual Content

3

4.

1. Neatly typewritten table af contents for each voluzne, arrangad in systematic ord• a. Contractar,. name of respansible principaf, address and telephone numberb. A list of each product required to be iiicluded, ind xed ia content of the voluinec. List, with each product:

1} The n me, address and teIephone number of the subcont•actor oz• instalIer

2} A list of each prod zct requu-ed io ba iiicluded, indexed t content of lzevoIume

3} Id.entify area of responsibility of each4} Local sourc of supply for parts and replace nent

d. Identify each product by praduct name and othet• identifying symbals as setforth in Contraci Documents.

2. Product Data

a. Inciude only those sheets which are pertinent to the speci ic product, b. Annotate each sheet to:

1) Clearly identify speei c product ar part installed2) Clearly idantify data applicable to instailation3) Delete references to inapplicable infornaation

Drawings

a. Supplement product data with drawings as necessax to clearIy iIjustrate: 1) Relations of coznponent parts t f equip nent and systezx. s2) Control and flaw diagrams '

b. Coordinate drawings with in% rmation in Projact Record Document to assure

correct ille stration of completed installation.

c. Do no use Project Record Drawings as maintenance dravvings.

Wriiten t xt, as required to supplemeni product daia foz• t e particuIar installation: a. Orgaz ize in consistent format uilder separate headings for different procedures. b. Provide lagical secluence of ins- uctions af each proc dure.

C1TY OF FORT WORTH CC Moss• aud ML Pliillips SRTS ImprovemenYs

STANDAI: D COIdSTRUCTTON SPECIFICATION DOCUME I"i'S CPN I U2411

Revlsed December 20, 2012

ai s a3 - 3

QPEI ATION AND ] v AINTENANCE bATA

Page 3 of S

S. Copy of each warranty, bond and se vice contract issueda. Provide information she t for City personnel giving:

I) Proper procedurres in event of faiIure2) Instances which might affect validity of warranties or bonds

C. Manual or Materials and Finishes

1. Submit 5 copies af coinplete manuaI in £mal form.

2. Content, far architectural products, applzed materials and iinishes: a. Manuiacturer's data, giving full infnrmation on products

1) Catalog number, siae, composition2) Color and texture designations

3) Information required for reordering special inanufactured productsb. Tnstructions for eare and maintenanee

I) Mai ufactuarer' s • eco runendation for types of cleaning agen.ts and methods2) Cautions against cIeanin.g a ents and nneth.ods which are detrimental to

product3) Recornmended schedule for cleaning and maintenance

3. Cantent, : for moisture protection and w a er exposure products: a. Manufacturer' s data, giving ull infot aation on products

lj Applicable standaa• ds2} Chemical com osition

3} Details f installation

b. Iustructions for inspection, maintenance and repair

D. Manua! for Equipment and Systerns

1. Submit S copi s of camplete manual in iinal foim.

2. Content, for each unit of equipment and system., as apprapriate:

a, Descript on of unit and camponent parts1) ' unction, normal operating cha:racteristics and limiting conditzons2) P rforman.ce curves, engineering data and tests3j Complate nomenclature and cotr tnezcial number ofreplaceable parts

b. Operating proceduras1) Start- up, brreak- in, routine and normal operating insiructions2) Regulation, cantrol, siopping, shut- dawn and emergency instructinns3) 5ummer and winter operating instructions4) Special operating instructions

c. Maintenance procedures1} Ro. tine operations

2} Guide to " trouble shoating" 3) Disassambly, repaie and reassambly4} Alignment, adjusting and checking

d. Ser icing and Iubrication schedule1) List of lubricants r quired

e. Manufacturer' s printed operating and niaintenar ce insh•uctiaaasf. Descriptian of sequence Qf ope• ation b}+ coz troI manufactucer

1) predicted life of paxts subject to wear2) It ins recommended to be stocked as spare parts

g. As i stalled cont• ol diagrarns by contrals manufacfurerh. Each coniractor' s coordination drawings

1) As installed colar coded piping diagra:ms

CITY OF FORT WORTH CC Moss aud NfI. Phiilips SRTS Irr provementsSTANDARD CONSTRUCTI03 I SPECIFICATION I] OC. TMENTS CPN 142411

Revised December 2U, 2U12

or aa3- a

OP I2ATIpN AN37 MAINTENA ICE DATA

Page 4 of 5

I.

J•

k.

Charts of valve tag numbers, witl location and function af each valveList of original manufacturer' s spare parts, mauufacturer' s current prices, andrecommended quantities to he ffiaintained in storageOther data as t•equired under perti ent Sections of Speci cations

3. Content, for each electric and electronic system, as apprapriate:

a. Description of system and component parts1) Func ion, normal operatzng characteristics, and limiting conditions2) Perforinance cur es, engineering data and tests3} Complete noinenclature and camznercial nu nber of replaceable parts

b. Circuit directories ofpanelboards

1) Electrical service

2) Controls

3} Communications

c. As installed cnlor coded wiring diagrainsd. Operating procedures

1) ou iiie and normal operating ii structions2) Sequances t•equi ed

3) Sp.ecial operating iizsta uctionse. Maintenallce procedut• es

1) Rou#ine aperations

2) Guide to " t ouble shooting"

3) Disassembly, repau• as d reassembly4) Adjustment and checking

f, Manufacturer' s pa•inted oper•ating and maintenance instructioi sg. List of ariginal manufactur r's spare parts, manufacturer' s current px•ices, aald

i•ecamm nded quantities to be maintained in stoiageh. Other data as req ired under pertinent Secti ns of Specifications

4. Prepare and incXude additional data when the need for such data becornes apparent

during instruction oi City's personr.eI.

1. 7 CLOSEOU' i' SUB1t lITTALS [ NOT IT ED]

1. MAINTENANCE MATERI iL SUBIVIIÌ'TALS [ NOT US+ D]

1. 9 QIIALITY ASSURANCE

A. Provide operation and maintenanee data by p rsorinel vvif tlae follo tvi ag eriteria: 1. Trained and experieiiced in maintenanca az d operation ofdescribed products2. Skilled as technical r vriter o the extent required to communicate essential data

3. Skilled as c1• aftszz an aampetent to prepare required dra vings

CIT' Y pF FORT WORTH CC Moss and ML Phillips R'fS Improvements

STANDAl2i7 CONSTRUCTION SPECIFICATION AOCUMENT5 CPN 102411

Revised December 20, 2Q12

ai 8as- s

OPERATTON AND MAINTENANCE I3ATA

Page 5 oi S

1. 10 D LIVERY, STORAGE, ANll HANDLING [ NOT USED]

1. 11 FIELD [ SITE] COND TrONS [NOT IISED]

11 WARRANTY [ NOT USED

PART 2 - PRODUCT [ NOT U ED]

PART 3 - EXECUTION [ NOT USED]

END F SECTION

Re ision Log

DATE NAME SLIMMARY O CHANGE

8/ 31/ 2 12 I. Johnsan 1. 5. A. 1— title afseetion remaved

CITY OF C3KT WORTS CC Ivioss and ML Phillips SRTS ImprovemenYs

STANbAl2D CONSTRLICTION PECiFICATION DOCIINiEN" 1 S CPN 102411

Revised I?ecemher 20, 2012

Q1 78 39 - 1

1' R07ECT RECOItD DOCUMENTS

Page 1 of 4

SECTION Ol i8 39

PROJECT RECQRD DOCYJMENTS

PART 1- GENE r.

1. 1 SUMMARY

A. Section Includes:

Work associatecl rrrith the documenting the project and recorc ing changes to projeetcloc rr ents, includzng; a. Recard Drawings

b. Water Metar Se rvice Reports

c. Sani y Sewex• Seivice Repo tsd. Large Wxtea- Meter Repfl ts

B, Deviations from this City of Fo Warth Staudard Specificatzon

1. None.

C. Related Speci cation Sectians inciude, bnt are not necessarily Iimited to: I. Division 0— Bidding Requirements, Can#ract ' orms and Conditions ofthe Contract2. Divisian 1— General Requirements

1. 2 PRICE AND PAYMENT PROCEDIIR S

A. MeasuremEnt and Paynn.ent

1. Wotk associated wit this Item is considered subsidiaty to tl e various Items bid. No separafe payment will be allowed for this Item.

1. 3 REFERENCE N T iTSED]

1. 4 ADMINISTRATIVE REQU.IREMENTS INOT USEDj

1. 5 SUBMITTALS

A. Prior ta submiiting a request for Final Inspection, delive Praject Record Documents toCity' s Project Representative.

1. 6 ACTION SUBMC'I'TALS/INFORMATTi NAL SLTl3NIITTALS [ NOT USED]

1.' CLOSEOIIT SUBNIITTALS [ NOT U ED]

1.$ MAINTENANCE MATERTAL SUBNIITTALS [ NOT USED]

L9 QUALITY ASSURANCE

A. Accuracy of Records1

2.

Thorougvly coordinate chang s wi in t. e Recard DocLu aenfis, making adequafeaiid proper ent• ies on each page af Specifcations and each sheet of Drawings andotl er pocuments wliere such entry is required to show the change p•aperly.

A cua acy af records shall be such that futur search or items shown in the ContractDocumeuts r ay rely reasonably on inforination obfiained fi•om the ap roved P• ojectRecard Documents.

CITY OP FORT WORTfi CC Moss a id ML Plullips SRTS Tmprovements

7'ATIDARD CQNSTRUCTION Sl' CIFTCATION DOCiTMENTS CPN 1 Q2411

Revised . Tuly 1, 2011

01 78 39 - 2

PR07ECT RECQRD DOCiJMENCS

Page 2 of 4

3. To faciliiate accuracy of recards, make entries within 24 hours after receipt ofinform ation that the change has occurred.

4. Pro ide factual inforrriation regarcling all aspec s of the Work, bot,h concealed ar dvisible, to enable future modification o the Work to proceed without lengthy ande pensive site measure nent, investigation and examinatio:n.

1. 10 STORAGE ANll HANDLING

A. Storage and Haza Iing Requir ments1. Maintain the job set af Recaxd Docu x. ents completely protecte i fram deterioration

and fram loss and damage unttl completion of t. e Work and transfer of aIl recarded

data to t e final Project Reco:rd Documents.

2. Tn the evei t of loss of recorded data, use z eans n cessary to again secure the dataio the City's approval. a. In such case, provide replac nents to the standaxds ot•iginally requiz•ed by th.e

Coniract Documents.

1. 11 FIELD [ SITE] CONDITIONS [ NOT iJSED]

1. 1 WARRAN'i'Y [NOT USED]

PART - PRODUCT

21 OR NER- FT11tNISHED [ oR] OWNER- SUPPLIED PRODUCTS [ NOT USED]

2. 2 RECORD DOCUMENTS

A. Job set

1. Prompily following receipt of fihe Notice to Praceed, s ct• e from the City, at iioch.arge to the Contrac or, I complete set of all Docu nents comprising ihe Contract.

B. Final Record Documents

1. At a time nearing the completion oithe Voi•k and prior to Fxnal Insp c ion, rn ide

the City I complete set of all Final Recox•d Drawings in the Contrac#.

2,.3 ACCESSORTES [ NOT II ED]

2. 4 SOURCE QiTALZTY CONTROL [NOT U Ell]

PART 3 EXECIITYON

3. 1 INSTALLERS [ NOT USED]

3. 2 EXAMINATZON [ NOT USED]

3.3 PREPARAT ON NOT USED]

3. 4 MAIlVTENANCE DOCCIMENTS

A. Maintenance of Job Set

1, Immediate y upon receipt ofthe job set, identify each of the Documents wiYh thetitle, " RECORD DOCLJMENTS - JOB SET".

CiTY OF PORT W012TH CC Mqss and h9L P1vllips SRTS ImprovementsSTANDARD CONSTRUCTTON SPECII' ICATION DOCiJMENTS CPN 102431

Revised Ju[ y 1, 2011

017834- 3

PR07ECT 1tECD iD DOCUMENTS

Page 3 of 4

4.

2. Preservation

a. Considering tlie Contract completion time, the probable number af aecasionsupon which tl e jab set n ust be talcen out for new entries and for examinaCion, and the conditians under which these activities will be performed, devise asurtable method for protecting the job set.

b. Do not use the job set for any purpose except er try of new data and for reviewby the Czty, until start of transfer nf data to final Praject Record Documents.

a Maintain the jab set at the site of wark. 3, Coordination with Construc ian Sutvey

a. At a nfnzznum, in accordance witI the intervals set forth i Section O 1 71 23,

clearly mark any dewia ions from Contract Docu ents associated withiilstallatinn of the znfrastruciure.

Making entries on Drawingsa. Recard any deviations fram Contraet Docuznents, b. Use an erasable colored pencil ( not ink or indelible peiicil), clearly describe the

change by nraphic line and note as reyuired. c. Date all entries.

d. CaII aitention to the ent y by a" cloud" dr•awn around the area or areas affected. e. In the event af overlapping changas, use different colors for the ove• Iapping

changes.

Con ersion of schematic layauts

a. In some cases on the D•awings, a•rangements of conduits, circuits, piping, ducts, and simila• iiems, are shown schematicalIy and are nat intended toportray precise physieal Iayaut. 1) Fina1 physical a t•angement is c etermined by the Contractor, subjec to the

Cify' s appraval. 2} However, desig;n of fut re modi' icatioz s of tl e facility may require

accurate information as to the fmal physical ayout of iteins whieh areshown only sehematically on the Drawings.

b. Show on the job set of Record D a vings, 6y dim nsion accurate to vvithin 1inch, he centerlina af each run of items.

1) Final physical arrangement is determined b the Cont•actor, subject to theCity' s approvaI.

2} Show, by symb l or note, the rertical loca ion of the Item (" under slab", " in

ceiling plenum", " exposed", and the lik).

3) Maice all identificatian sufficien ly de criptive that it may be relatedreliably to the Speeifications.

c. The City znay wai e the requirea ents for conversion of schematic layoutswhere, in fihe City' s judgment, can ersion serves no useful purpase. However, do not rely upon waivers being issue except as spacifically issued in writingby the City,

B. Final Praject Record Documents

1. Tz•ansfer of data to Drawings

a. Carefully iransfer change data shown on the job set oiRecord Drawuigs to thecorresponding fmal documents, coordinating the chaingas as cequired.

b. Clearly indicate at each affected detail and other Drawing a full descrip#ion ofcha. ges znade during construction, and the actuaI location of iteins.

CITY OF FORT WORTH CC 1V( oss a d MI.. Pliillips SRTS Iinpravements

STANDARD CaNS' T`Ri1CTFON SPECIFICATION DOCUMEN' I' S CPN 102411

Revised luly 1, 2011

017839- 4

PRO] ECT RECOI2D I70GiJMEN" i'3

Page 4 of 4

e. Call attention to each entry by drawing a" cloud" around the a rea or areasaffected.

d. Make changes neatly, consistently and with #he proper znedia to assurelong i.ty and clear reproduction.

2. Transfer of data to other pocLunents

a. If the Documents, other fhan Drawings, ha e been kept cIean during progress ofthe Worle, and if entries t lerean have been orderly to the approval of the City, the jab set of those Documents, other than Drawings, vilI be accepted as finalRecord Documents.

b. If any such Document is nQt so appraved hy the City, secure a new copy of thatDocument fra n the City at the City's usual cha•ge for reproduction andhandli g, azid carefully transfer the change data to lie new copy ta the appro alof the City.

3. S RtiPAiR / RESTOItATION [ N T USED

3. 6 RE- Il iSTALLATION [ NOT USED]

3. 7 FIELD [ oR] SITE QUALITY CONTROL [ NOT USED]

3. 8 SYSTEM STARTIIP [ NOT USED]

3. 9 ADJCTSTII IG [ NOT USED]

310 CLEANING [ NOT USED]

311 CLOSE UT ACTN TlES [ NOT USED

3. 12 PROTECTXON [ NOT IISED]

313 MAINTENAIVCE [ NOT IISED]

3. 14 ATTACAMENTS NOT iTSED]

END OF SECTION

12evision Log

DATE NAlVIE SLTMMARY O' CHANGE

CITY OP FORT WORTH CC Mass a id Ivil Pl illips SRTS ImprovcmentsSTANDAI2D CaNSTRUCTTON SFECIFICATIONI70CUMENTS CPN 1Q2411

12evised July I, 2011

APPEND L

GG6. 06.D Disadvantaged Business En#erprise Gonnpliance

Ci'I" Y OF FORT WORTH CC Moss and ML PFuIlips SRTS Improvements

STANDARD CONSTRUCTION SPECTF'ICATION DOCiJNI: NTS CP]+I 1U2411

Revised 7uly l, 2011

C o 60 ] Dis l nta ] usYness ] E te° is

Il ce

I[][S PAG ] LE"' I 7C] El TA.' ] LAl

C1TY OF FdRT WORTH CC Moss and ML Phillips SRTS Improvements

STANDARD CONSTRUCTIOI! SPECIFICATI N DDCCINlEN T' S GPN 102411

Revised duly l, 2011

101 4121, 7: A4 AM B2Gnow

v o o r T a

o ac u o c n n a

b s o n us o t i nn v

r, n r r n ov

o: Depa tment Project Manager

Fram: O rice of Business Equify

a e: October 14, 202

In he moun of: $1, 44 9, 726.40

oOElProject No.

r c' d. . C, llloss and II!!I. . Phillips SR S Impro em n s

Compliance r i h the Cifiy' s i ad antag usines nterpris rogram

has been hie ed by fihe folla ing m thad:

i O T 1S% R iV TRU TI IV, LL is in compliance wi h the Ci y's DBE Program

by commifting to 8% D parficipation on his projecfi. The Ci y' s DB goal on fhis

project is %.

CC Moss and ML Phillips SRTS ImprovementsCPN iQ2411

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usiness quity i i ion Speci ica ion

P I! L IR STRUCiI N OR OI F i BR

Lic ion o o icv

If the total dollar vafue of t e City funded contract is $ 1Q0,000 or mnre, then a usiness auity contracting qoalis applicable. '$ ' -, li '( jlllEjl F Fll i 1' 8 6 a rtn ed irn.; ntiv6 8i i l"Jr 4 r`C) 17aEi=, DtYeicil 3lfs lt v L. Ii1 F 1' I5E's

nlilWf3t).

O ICY SiAi M NT

It is the policy of the City of Fart Warth ta ensure the full and equitable participation of Business Equityjrmc nnMicabV, :? trp procurement of all goods and services. All requiret ents and regulations stated

i the C rty' s current T u5l less tqulty G C!? anCe I. _. . apply to this bid.

HUSI= - Sr 11 Y A,

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A! jCY11ASR Fl,7 ItV r me i antr2 ctor c: n cnunt ii S :: if-perFormanca services tcwards maating th Lusin ss E uity Gaal fnrt lv' BVsion[ f NR;. nmmnriit l Li' S O: 1 isp! r 111iFk Qi {`, BF rgrtifrafiinn, Jf thU FZs cin gg r ii±

v Priml nnSrarfnr 4nnnl

elf- rform a!! =t th work, it v:!! ? : ccaunitabie or subcon#racting with certified u iness Eq+yity firms ta i i p? fi tt a c verailial,

o n iar C`. Ia i $ r Cl iclal

Gkt1 i: ity f lfl 6d 4,?ntrartS 9QQ, QQ(} nr m re wher a La GinRss qu ity G I IS ? polieei, o: r4rS re rar uifed i4 r.nmply Wlththe Irtter t tf e Ity a la$ IiIES$ 71 IY f GfCflfl$ nf,:P by m et n or YrP r3ing tlle; ho e si2led goal i ro gh 4ne af theu 10 N1^[ I' rlErhpric: '. lJSl 1 S5 Quit 3u Gnntr r in pd1tlC p t on, OC, '. GQmmnrri i ,+ gf l { y n Finh canrirag

ertorrned f3y the ; s npa tiuiiv Prime t c t 4owards qh oak, or; 3. Ga mbination of I inwcs uity ' I! le

S IYIC S 3f1(' 5!? ss aujtV ubcnntractincr e arficipation, or; 4. Busin ss s uity .Eoint en#urp participation, c r3 . QOd F i#h fFnrF rin_r_m nta$ign C"' . F;.',rr,?g Vf ivgp r nri mw# atiorl,

SU' i IITTA C? I EQUtlf[ 3 OC 111 I TAT1aN

L I PIi28t!^ Ei P II SI r.! I ' k Li$ $ B ttlY1P__ SnP__Cf pri in n .,.+ o ta± i. ' 1' i, e a lir_,hf OGL man4S must b

ceive! by Rhe Purchasing G i: c on, tnrir i! tl e tirn ! Ioc2ted, i a d r ti# sntire bad t B CL nsider esoonsivP

t i h fiaeGi. fic tibr ,. Th e QrPr si1211 € P ivc?r the Business quity dacum ntatior ir person { or emaiJ iF d? l nated

w+rjth projecl 5; r. ications C'J h aporoonate : mplayee of ±he Pt rchasiR Division and c!^# 7i11 Ci r? ftima p rai f. Sw'V11

re;;eip1 sl atl be e fi snce thal E# e ry rer.pi+ ed i}wA rinc; a; in€±ntat lt7f1 I! II time atic, ax r €] Cu!, nt are to s

Gf: VGC nn IgC- ( h t1 : i 0 [ 3. i1'Y,a

Yl f18 wYcand Citv husiness t wV af!'!' rh d dpening d ta, X l civa t? ltJ

o Oe nfng € la±d. F xed ct pies will r: t : apteei. e tion: CF, IG4, aiYd D?' p!~, j c#s, yacume:: ts plt a

g ihmif°t d tn rha iry ;: ,; ect + nager if publicly bid u r ta t e r lnoer if privat iy + id.

rflc # C: ^: S1L SIJI5171} (} M'9 Of E?' ii'±1} r vvin C;. qm. ntw FRnYI-

j _ L9? Ilftzafi:l"- n rC!' f, f * n eioaF ; fi met ar ex? eded, nd signed _ - ro; s w; tnt t ff4r11 '.) th in ( fferar T1' Uk,_ t nTr r.+r(Sj, 7 .:} 1 L tlrl S: n7 n:; 4 : iYiy tive! iJr, InG1q r9in SL4? k 1' Ilfi o"OC1 IliBClt lt?tl, If artjritn, a+in y 15 R S ` han tats g l,

C!' tb L3ujnF S E Uitr nar'ti ir atio IS r.r.nm ulichPrl_ nr SlUfteCl I., L# i!' s 4 ^ t nf f^ f C: j/ a. 7Glnati, BCF, aL a-

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City Proiect No. 10241 I

FORT VORTI:

I O Oi' t AI"' l

usiness qui ivi Eon

ime Gon ctor IIVai+ r Fofm

NAME:

PROJ Ci NAM: a u

C fVloss and II L Phillips S iS Imrprovements g 3012021

ity' s Business quity Gaal: Offeror' s Business quity Project Commitment: PROJHCT

L rQ 411

GF ith ancwprg tn thiS fprm arQ YES, do nat carriplete ATTACHM NT 1 C( Good Faith EfFort arm). Ali q rp,+ ions - rhis Fnrm must b rnrrzpleked and pro ide a detailecf explana# ion. If ihe answer to eikher question is [ o, hhen yaui ust cornplete R`? ACHMFNT 1 C, Thi form is only applicable if both answers are yes.

Fa jli r± tr _r_gmDlef t llS ? ff". I' r1 iiS +^# I wa! jf li d f+ ;:,:. rn y [ h6 PChaS' tY1 !# al 1 !} I E 313 2: 3

m,, on the ecan Ciky ar ass d y after bid c penin, exciu ive of t e aid op ir g date, wi E res lt inip@ M?! L ? @I17q CO1lSIC BiB( f!!?+ 42 a brlsjV tp j;:+,' ' arifir- tinns. Cx e tl4ri: CFA, , dk. 1?[ a' 1rb) Cl'Siocurr er wiil I e s: f mi# e # he City Pro t Ma a r i 19 iy bi or tn tF Develaper if r:vat+ ly bid.

Nill you perform hi nti p rhe, tira_r.t urir ouf subcon rac ors? Y

If ; res; 1 ase pra ide a+ at} ed x lanati r th t prn r s b sp J on ih s ze ar.d 9 nna o ihispr ject, [!: s i* your ormal l usiness practice nd pr} i e erational } r€! e f y! r b usiness.

iid!! au per#'o m tihis entiir e contipact without supplier s?

If ; res, pE ase i vide a pta, lPc x! anWrj n tt?# pr[ ves t+ass an ihe saz at; i 4coo o # hispraject, this is your nGrmal l sinpss r cti e and prt?Vl p E3n ir ventory ra' iie of cur b siness

o

I YES

I NO

7ffiti rirn l i rar fur rh r agreas o #} rnrilCiP, V. re t!y o #+ Efy u rr re ues±, cornppe, ryd ar.curate

anforr-natior r arding a4tual wo• k perfarmed k; II s, t contractor , i cludin i Sir ess ity fi ms n th s cpntract. ihe vmeni h' ranf ar d ;?! ty r000sed chanaes # +.! tigiral B<. iness C?] UIfV iir i f l1 ILf1lEt I.5 SLJ J f; I+ p :• i# h

t s bi Th r' Irr, a?? rnr Iso agrees t Ilt w art a t an ltnr Pxart tn t Gt1 f a boo! s, rer.o s # iles I pfd

bv tE Pir . ompa y that ^! ll s, stantiate ihe ci, a3 , rrork ertarmed `vy i 1 lf inac5 ultV fi1' 1' f!5 !' i5 Cnntrarf

11 e'EtJfhn' 12@' O{ IGef r mnln C]{ fla I#. 4i1] IP.trw, ry{ in,ng{ Lnr lnf i41h'. f1Cj 17ticran cantat nh {,' f e''„w+ Y'J l

bs gr unds # r ie,rminating the c rrtract r d+ arr e tfrom C I 1R fk fw^.; : 1Erjnri ,+ f I rJt ESS lh?, tFlr }` ears

and for init a+,n Ctl i1 fJflLi? l?C 4'_', iata ,+ r pra 1? tus cancerning f ls u±aramallt5. Il idilafi? t COf]'! f Wdt l

fiis 4rrSin: 3l GE C!-e8t s a matnriu! ` r aCl of ,+ ntrar s i R? Y! f Si k If1 C. arminatip' 1 4f L 1 IrfL SL'r0T] SI aflfY E

rFgrnr nr1 l7gffed f R^: articlpating u!? ty ; v rk ," iPrI CI r i!?? nat ? s #1 an ne ( 1) esr.

tnnrized Signature

7iil

omUany ame

4d(: f955

Cdtv/ SrasF:.nir —....—• ---w— - —

u iness Equify E isianmall: DV N BEOffic.elc fortw ht xas. ov

p'^^ p: l 817 3a- F q +- r! ncc nd rJIL hillins S!? 7' g li:?nro emc nis. Cphf 102? 1, 4cir Pndurr

rflfltP_f Ifajj'dtu.

Ca^# ar7 N me ( f afi€ rent}

Phone fumber

Eryiail f irjrr,.,.g

L}$ tN

ATTACHMENi 1B

Pag 1 df 1

Chec[c applicable box ta describe F; irnPt

fFective 01d' 112027

7n, z, 5 14ii. l iilli. R' I' k,;: pn; veufen:, L: ity i' rol ci hli. ! rti_ 41 I

RT R'- I, City oi Forr IIV'orth AiTACFiIVA WT 9C

usines qui y i i ian age 1 of A

ood aiirh fo t Fo m

PRIMEIQF RO!{ Check applicable box ta describe

COMPANY NAME: Prirnelbfferor` s Certifi akion

c3 i, ; h.'nn_ ,.., _

PROJECT IVAME. F - qu,

C Moss and NiL Phi{ 1i s SRiS [mr rovementsgl bATE

p p 9/ 30/ 2021

6usiness Equity Goal: Offeror's Busfness quity Goal Cammifineni: f' ROJ Ci NUMBER

S, 0 % uo

10241

If the Offeror did no# meet or exceed the usines$ !; ifv Goal for this project, the PrimelOfferor r+ust complptPthis form..

p he mel PP r°s meihod of compliance with fihe usiness quity w! ; I as+ d

pnn pmonsltratien of " a+ aith fFvry'

y fhe rimelOiferor will have the burden

o rectly a^ a: , r r iy preparin a nd fimiraina he dncum nfaiinn rec ui ed b r h

4, r mpliance wiih each t m, ' hPu f0 be ow, haf1 satisf_y the 9od Faitih E Qr

I"E.' ClLI11' BEl' I ilt tya n# irnnt # fra yd, ! r!+_ ntional andlor knowing r.:i representa# ion o e facts

r r +nter iona discriminatign by r mel0 ie o.

ai ure t `?? 4iE e tnis toPm, n :* * nt Pety Wlill suppnrun aocumenta[ on, ana recetvea uy tneI u Chrsing G yvi so no I i: t n :+ J p. m. on tl e sec ond C€ ty b sine 5 ? y , f+ar bid op ening, exV!;: w:.' sof id o nin #, +.. ill r.6sust e: i 1 1 ping c^! are r an-,* pon$ ive tn qid ec fie3fi4^ s.

Excent n: FA, CwA, a!± ? rojects, documents v r!! f e i hmik# d Ch9 C:± v iL; c# M' e if

3ubli l ' t id ar tv : w l v 4D1 w If [ 7• s± p y bid.

1.} F' I as Bls h !! d e' rY u rnptractinv andl4r u n Yipr o artunit ir•P tk! ompE ti rt sf zhisroiect, r s ardl ss c f r vhe her it 6 t be provided y a Y ness q Eutv 1f rm o.* nan- rsiness

qu itv irm. 1 30 r'dOT LESi t 4M 5 l7F I t19 5]. n } proieci s; 3± w ; rimplCi' FP_ fS t U t e cfn

j 4p r t1 j ,{ r GIIYIIP nr Q unlfY r gardl s:, O f IR[.

1se a it ona! sh ts, f ra r, ssarvj

P4: oss and 1 4 ' hrll ns RTS Emqrovements, CI A3 s( 12d7 l, Ar_v pnri i!? I 1tt tive ' ItD rzpzi

S 5(' ] ns5 :: d. IV Phdllps SRTS ia[pruvemen 5ityPraiectNo. 102411

ATTI ICHIU NT '[ C

age of a

2. a Obtain a c rrent ( not more than two (} months old from the bid open date) list af Business quitysubcontractor5 andlor supplierrs fPom the City`s Business Equity Di ision.

Yes

FVo

Date of List ng

3.) Did yau solicit bids from Business Equiiy firms, within the subcantracting andlor supplPer areaspre' rausiy listed, at least ten calendar days prior ta bid opening by Eele ahane, excfusive of tf e day hebids are opened?

Y S [ ff yes, at ach Ifst to include ame of Business EquiEy firm, persan cantacted, phone number and dats and tlme of cantact,]

No

4,) nid you salicit bids from Business Equity firms, within the subcontracting andlor supplier areaspre iously I sted, at least ten calendar days prior to bid opening by fax, exclusi af the day the bids areopened7

Yes f yes, at#ach list to include name of Business Equity flrm, fax number and date and time of contack in addition, if the fax isreturned as undeliverable, then that " undelfverable canfirmation" recei ed m tst be printed direct[ y from the facsimi[ e for

proper dacumentation. Failur: to submit confirmation andlor " unde[ iverabfe confirmation" documentation may render the

NO GFE non- respnnsi e.)

id you sollcit bids fram Business Equity firms, witi in the subcontracting andlor supplier areaspre[ ously listed, at least ten calendar days prior to f id o ening by email, exclusi re of the day the b ds areopened?

Yes f f yes, attach email confirmatlon to include name of Business Equitq firm, date and time. In addition, if anemail is ret rned as undelirrerable, then that " undeliverable message" receipt must be printed directly from the

email system for proper documentation. Fa[ lure to submit confirrnation andlor " undeli erahle message'° documentatiort may render the GFE non- responsive. j

hi[] i: ' fi M L l Q mPfhnrlS irl tlfl4d ' d1] C.' 9 P@ CC tahl9 Qf so icitin 7 d5, : id ? at`!h selected

e!'! wd rY! st b applied n the p l[ caV! : onteaat. Thp Primel0fferer must dacurr. en# that Ither at,

east #+ a ttern r_s ! P? ma+ P zsrn iw f th 2hree met rads ar riat at Ueas# nne suCcessful contact was

71 C* J5111Q { pf1°` of *.?^ thre ' IBtFt(] i;S Ifi ' 4.+P nf' O C F'pf?? 4' B5 nnSlVE t4 l'I?n ' 3t, c F i h ffart reqt Pp;.

1[? TE: ' F ta wimPlClf arnf m„ _ r_r tact th entir Busir ess uity t ana lflC ea: 1

ubcnniracting n sup# Qr ppor tunity o g in ! n f nc with a fiians 3 hru .

6.] Did you provide plans and specif cations ta potential usiness Equity firms?

Yes

n

7. j Ibid y prnrride he infnrrmatinrr regxrding the o atian uf ! ans !: d pecificatians in oede to assistthe 43usiness I quity lfirms?

Yes

Nr

CC Moss and ML Phil ips SitTS Improvements

City Project Na. 1 U24f 1

CC sa a; l 4L I Mi!! ips SRTS improvements, CPF D2411, Addendum 1E fi e D9101/ 2021

ATiACH IENT 1 C

Page 3 of 4

you prepare a quotation for tf e Business Equity firms to bid on gaadslservtces specific to #heirskill set?

YBS ( If yes, attach all copies af quotations. j

No

9. j Was the contact infopmation on atty of the lisiit gs not alid7

Yes If yes, attach the information ihatwas not valid in orderForthe Busin ss quity Di ision to address

khe correctians needed. l

IVO

9fl,} Submit documentation if t inass uity fiirrrEs quates were Yejec# d. ' he documentation suhmitted

should be in the firms forrris of n f: it, Gnclude a detailed explanatian f why fhe Business Equity frmswas rejec#ed and any supportir g da urnentalCion the Pr9m Off'eror wishes to be considered by the City, ln theer ent of a hona fide dispute concern4ng quates, the Prim lOfferor will provide for confidential in cameraaccess ta an inspection of any rele ant documenfatian by City personnel.

Please use additfanal sheets, if necessa , and attach, nm an Name Tele hane Cvntact Person Sco e of Work Reason for Re' ection

1

i

A,abITiO EA Ih1 0' M! vION:

ple s yrovic# e efeiitianaf nformation + vu e! w+ I1 rr ri. e plain yaur oad nrl honest efiforts tca h*_a nBtl c a S C 6tV fj; m TtiCioation n this proiect.

i he P:r:+ f 1` ar?* f!? her rees fe , ra. i, 7ir G: ly to ! i r a on r q est, gm ia nrl rra ra te Jr'1i fDrmaTinr r qaPC ICI + t!? j avorE er°frormed Oi 15 CD ia;

avm n# # n r ar a: pro osed char es tr # he riginal rrang ments +, bmitt c

a fiF his rl. T e ! nel f eror ! c are s to a low ar u i nt lor Y mo na ion f nyg, cn+ s nd il ald R y th eir com ny h t +!+'Ml u stan iafe !! ;: al .. ar

per vem d # s car t a, ] JI I 3U ilp1' IZ( O$$lr w DP' I11p OVBB [ 3 il 9 y.

4 arr p 9 eror whr ant nti r l y n dl r nuwingl ±? srepresents rna ria t . n. p!

A4 arrec ar a peri ad + m af u t fess #h r hree } y rfi.

C 4+?. ss + nd h+ll. J7: i! li s R7 Jm;. rr vrane:nty

v Yrniect 1'n 1!!'' 4 I i

C MOvS 4nr 11AI jill in,S 1 T P!:? r v'? fherlY ! N L17411, , 4dd ntiiur y fT@^ YIY@ k71: D1 421

AiTACH IpENT ' I C

Page 4 af 4

ihe undersigned cer ies ha4 ihe information p ovided and fihe usiness quity firmslisfi d wraslwe e confiacfed n good ai4h. I is undeYsfiood ha ny usiness quify firmslisi;ed in At#a.chmenfi 1G will be confac ed and he reasons or no using hem will be

veri ied by iF e City's usiness qui y 9i ision.

Au#hopized Signature

Title

Company Name

Address

CitylStatelZip

8. 0

Printed Signatu e

Contact Narne and Title ( if difFerenij

Phone Number

mai , 4ddress

Date

Business Equity DivisionEmafl: DV1iV BEOffice@forfworthtexas. govPhone: ( 817) 392- 2674

C 1, n• s5 vk1 ; E_ I}} 11 iipc SF'$ finrr yemehl5

Cih1 Prbier: ' Nn. j i i I

C y4C: 5 E^ ML h! I: r".S S! TS ImFmSrPmante ++` '+' i' , prJr endan, l Effective Q' 10!?( 1

T Uo r CITY OF FORT WORTH

Jnint Venture Eli ibilit,y FormAll r uestfans must be a rswered; use " N/A" if noi appl8eable.

Name o€ City project: CC Mass and ML Phillips SRTS Improvements

A joint venture fotrn niust be completed on each projact

RFPBidlProjectNucnber: CPN 102411

1. Joint venture infarmati[on:

Joint Venture Name:

Joint Venture Address:

IfQpplicableJ

Telephone: E- mail;

Joint Venture

Paga 1 of 3

c? ntify ihe firms tha comprise the loint venture:

Please attach extra sheets r addiiional ., oace is requrred to provrde era Ieu n;, afanations of work to 6e Wrforrned' f y eaCh frr.m w,mprising #hernf va.,aru•

Business Equity ]' nn- Business

m Name: E ¢ i Firm ivame:

BUSiLlCSSFiTC1 j iFwlr, s ii C= iU1IAC[ NaYY] C: i' Ol: t:::'i i." 7c;

J3i131I1` 55 ---- - k L'...... G ; f i!' CSS' A . s 4

7 cJ ps n,.;. Fsx. C le il7n e: Fax

F- li: ': 1- n,: ail .

2rti#:catinn St8#u5:

IVi^„ R f C' 4rtj' in tienc}•=

r.ope + f :=;.rk p rfa med 1.!! ll kP.±i.+r*:

1} C5' ii'Ll@ 1i: t SES.' UC O S1' h!' IF lh i 3751R65.5 UJ' !'![ I: srrihe lhc gt r. t: f +'ci iL ik I If' f.lOYl=' ui:n='c9 Y' lil}' ! Y' lt71;

t: C ,yloss :+. d 1v1L k' h llips Sk 1 S Cmprovame tst iiv Feqicct No. 102 411

CC MasS v^ d ^ L phil ips P, S I; npr4vemehts. CF' N 1 2d1 1, tlddendum 1E? eciive €} l u, r? n?

Joint Venture

Page 2 of 3

3. What is tb.e percer tage of Bnsiness Equiiy fi• tx participation on this joint venture counting towards theproject goal?

Attach a copy of the joint ventu re agreement.

5. List components of ownership of ,joint ventttre: (Do not complete iffhas informatdon is descri6ed in joint ven#ureagreement)

Profit and lass sharing:

Capital contributions, includingequipment:

Other applicahle ownership interests:

6. Identify by na ne, race, sex and firm those individuals { with tities) who are responsible for the day- to-daymanageme nt and dec.ision making of the joint venfr re:

n;r• r;; Frcrn a d ftef he daie f prai ct avrar, if any cf Eh articipants, the individually defined scopes of work ort R Qiiar mour3tslpercenta es r, hang fmr-r, h riginally approved information, then the participants musiInfar r; Ehe C: ty' s Su F±? ss C ui4y !:! si n amme iatei{ f r appra al. Any unjustified change or

ieletior sh i fa a fpatgfial hrPa pf , rract nci rtnay r•A+ It n debarment in accord with the procedures4ui!i: II' 1 t. 1^-,.. . et' R rq r,' S Cf Ult C. rri rydfl 6,

CC Iv ss and ML Phillips 3RTS Impmvements

City Pmject Na. 10241 i

lhnss and a! I. I' hUli s ;,,', r 7' fE' Fm, pmy,ryr,c' vo p yp^ 1 f, Addendum j Effactive Oi10112b29

The C ty', B siness Equify Division wi11 review your joint venfure submission an wiq have

final ap roval of the Business Equity percenfage a plied #oward the goal for th pro ect fisted or thic fnrm

Jaint Venture

Pa e3of3

AFFIDAVIT

The undersigned affirms that the foregoing statements are t e and correct and include all material informafaonnecessary to identify and explain the terms and operation of the joint enture. Furthermore, the undersigned s11aIIagree to ro ide to the joint venture the stated scape of work, decision- naking respansihilities and pay nentsherein.

The City alsa reserves the right to request any additional infarir atian deemed necessary to determine if thajoini r enture is eligible. FaiIure to cnoperate aridla pravida r c uested infarmation within Y ae time specified isgraunds for terminatian di the aligibility pracess.

The undersigned agrae to permit audits, interviews with owners and examination ofthe books, records andfi es of the joint venture by any authorized representatives af tha City of Fart Warth. FaiIure to complywith this provision shal] result in the termirna ian. af any contract, which znay be awa rded ur der the pzavisio.nso this joint venture' s eIigibility and may iz. itiate action under F deral, State and/ or Local lawslordinancesconcerning false statements r willful nisrepresentatian of facts,

Name of Business Equity Finn: Name pfNon-Basiness Equiry F'um:

Name of Owner. LName }'{};;;; P; — —

I

natureii'{ iw.r! s Segna ure f4, s: - -

rinie l Wair r f wfi: t rTJntrrl Name nf Clwnrr

i,, tiai er trf Q r: er ii-: w,;_ , T n.,;; Pi —

Ti!! e

9. f;; rp k :+P

47] PP ! lt

Clu t: s

ri dti011

L„ nty U{

ay t t' ' f

artci

i}' t)C 4,'. r jy arr. i

tu siy ers naiiy 1` jnwz ., n r± o, laeing cduly swar r, €. : xew A1 C l#: F4] I' e 0ifl d itl Vli ! T! [ i t ytat l l, 3 r+,Yy . ere

ki1' i}+]L' j4' ta.vtnariz d E o e. cc.!! tl ia '!: F jarrii nd did so 3 the r t l"` a t nc i±?E'rl.

k Oi??+ 11' I} 1C —

ii: it T';'. f;; C

t-tary P li::

S i Gna urC

mmlCCial' 1 jC 1Y' P.0

EI51.^. 5 ' ikll' ;' icin

I ail; VCI I E'.[ 1.:( n t'i,rrurnrYhteaa_ oV

f [: h9 s 2 J I t Rniflips RTS improvement, CF"; 102a1i

i nne: (# i C ; } . -.:,, 7

se=F,1

C Mcss atid ".; , Ph ill! j7s tiRTS Int It7VGll1G1715C': y Yr ect A{o. ! r"?d l

Adde^ du! n 1

F i'- rii a f5 P111 7' i?%7

County Tarrant

Highway VA

Limits From: GC Mass ElemeniarySchoof o ML Philiips

Eiementary Sc.hoal in FortWorth, Te as

DI5ADVANTAGED BUSINESS ENTERPRISE

REQiT IREMENTS

The fallovving goal for disadvaritaged business enterprises is establish d:

DSE

S. 0 %

CC Moss a id ML P13il1i}, s 5RT5 ItnprovementsCPN I0241I

I) SAD'V. llTTt ED l TES El T]ERPRI ES

REQiJIREl IENTS

PROJECT: CC Mass snd ML Phillips SRTS Im rovements

HIGHWAY: VA

COUNTY: TARRA.NT

TXDOT CSJ: 0902- 90- 084

The foilowing goal for disadvantaged business enterprises is estabiished:

DBE

5. 00%

Ceriif cation of DBE Goa Attainment

By sigr ing tlae proposal, the Bidder certifies that the above DBE gaal wiI ba met by ohtainingcommitments equal to ar xceeding the DBE percentage or that the Bidcier will praaide a gnod fazth effortto substiiute the atternpt to tneet tbe goal.

FaiIure to provide commi nients to meet the stated goal or provi ie a satisfactory gaod faith effart will beconsidered a breach nf ttic requirements of the pr npasal. As a result, ihe bid proposal gaaranfee of fheBidder will be property of the City of Fort Worth and the Bidder will be excluded for rebidding oa theproject w aen zt is re-adverCised.

CC Moss aind ML Phillips SRTS ImprovementsCPN 1024I1

1; A e°. c

635.410 uy 4merica requirements.

a) 7he pravisEons af fhis sectian shall prevail and be given precedence over any requirements of this subpart which arecantrary to this sectivn. However, nothing in this section shall be construed to 6 contrary to the requirements of § 635.4D9( a) of fhis subpart.

b} No Federak- aid highway construction project is to be authorized for advertisement or otherwise authori ed to proceedunless at least one of the following requirements is met:

1} The project either. (i) Includes no permanently incorporated steel or iron materials, or.( ii) if steel or iron ma#erials are tobe used, all manufacturing processes, including application of a coating, far these materials musi occur in the Urtited States. Coating inc] udes all processes which protect ar enhance the alue of the material to which the coating is applied.

2) The State has standard contract provisions thaf require the use of dorrtesfic materials and products, including steel andiran materials, to the same or greater exfent as the provisions set forth in this section.

3) The Siate efecfs to include alternafe bid provisions for foreign and domestic steel and iron materials which comply witf the foliowing requiremenis. Any procedure for obtaining alterrtate bids based on furnishing foreign steel and iran materialswhiah is accepta6le to the i ision Administ ator may be used. The contract provisions must ( i) require all hidders to su6mita bici based vn furnishing domestic steel and iron materiais, and ( ii) clearly state that the contract will be awarded to thebidder who subrr its the lovvest total bid based on furnishing domestic steel and iron materials unless such total bid exceedsthe fowest tatal 6id based on furnishing foreign steel and iron materiais by more than 25 percent.

Q) WF n steel and iron materials are used in a project, the requirements of this section do not prevent a minima{ use offoreign steel and iron maferials, if the cost of such materials used does not ex eed one- te th of ane percent ( 0. 1 percent) ofihe total contract cost or $ 2, 500, whichever is greater. For purposes of this paragraph, the cost is tha# shown to b the valueof the steel and iron products as they are deli ered to the project.

c)( 1) A 5tate may requ st a waiver of the provisions af this section if;

ij The applicatian of thase provisions would be inconsistent with the public interest; ar

ii} Steel and iron materialslproc ucts are not produced in the Llnited States in sufficient and reasonably a ailable quantiiieswhich are of a satisfactory quality.

2) A request for waiver, accompanied by sugpa ting information, must be submitted in writing to the Regional FederalHighway Administrator ( RFHWA) thraugh the FHWA Division Administrator. A request must be submitied sufficien ly inadvanc of the need for the waiver in order to allow time for proper review and action on fhe request. Th FiFHWA wiil ha eappro al authority on the request.

3) Requests for waivars may be made for specifio projects, or for certain maferials or products in specific g: ographic areas, or far combinations of both, depending on the circumstances,

4j The denial vf the request by the RFHWA may be appealed by the State fo the Federal Highway AdministratorAdministrator), whose action on the request shalf be cor sidered administratively final.

5) A requ st or a waiver which invalves nationwide pu6lic interest or availsbility issues or more than one FHWA region maybe submitted by the RFHWA to the Administrator for action. 6) A reguestfor waiver and an appeal from a denial of a request must include facts and jusfification to support the granfing

of the waiver. The FHWA response to a request or appeal wiil be in writing and made available to the public upon request. Any request for a nafionwide waiver and FHWA' s aciion on such a req est may be published in the Federa! Register forpublic comment.

7) In cEetermining whether the waivers described in paragraph ( c)( 1) of this section will 6e granted, the FHWA will considerall appropriate factors including, but not limited to, cost, administrative burden, and delay that wouid be irrtposed if theprovision were nvi wai ed. d) Standard 5taie and Federa[- aid cnntract procedures may be used to assure compliance with' the requirements of this

section.

4B FR 53104, No. 25, 1383, as amended at 49 FR 98821, May 3, 1984; 58 FR 38975, July 1, 1993]

CC I+Ioss and ML Plilllips SRTS ImprovementsCPN 102411

I I S lJ PO ' aiEfV EiVT

Under 5ection 231 AOfi, Family Code, tf e r endar or applicant certifies that

th indi idual or business ent ty named in this cantract, bid, or application is not

ineligihle to recei the specified grant, loan, or paym nt and ac[c awledges that

this contract may be terminated and payment may be withheld if this certification

is inaccurat.

CC IVloss and ML Fltiltips SRTS Improvements

CPN 102411

tat f ' x hild uppor usines O+ nersh rp ' orrt9

CC Moss and M P illips

County: Tarrant Project Name: SRTS Imqrovements

TxDQT CSJ: D902- 90- 0 4 LG Project Number: CPN 10 411

usiness Entity Submitting id:_ Northstar Construction, LLC

Section 231. 006, Family Code, requlres a bid for a contract pai from state funds to include the names and social sBcuritynumber af individuals awning 5% nr mare of t e busfness entity submifting the bid.

1. In the spaces below pleas provide the names and sacial security number of individuals ownin 25°lQ r mare efthe business.

Narne Social Securify Numb r

i ichae A. H im icri

2. Please heck R_ h nx n low if no individual w, 2 nr more of +he business,

f fndivldu al arrun % u r more af th n c nes,

xcept as provided by artinn 3' j. 3Q2{ i, F mlfy Cade. gnr al cprLlCl} ki' L Ynl er is , r,n iripniial nf fFkwy iG C1JSC1# SC?( nlv for the nurnos of rn hn! r!g o r uest fp* i 7formatie r, fram aY genay oP rating u f h rrnrVYinn if arl

and to T'ttle IV € f th J= ederal cial5e urity et ( 42 USC Sectior aL-?? and 651- 699},

Under 5ectian 2,+? 6, Famlly C da, the end r ppfcant c: ificw5 hhaf j? 9 P!? 6 Y CILI I 0 k° Sf! 19CS Gn it amgd ' un Ihi

confraef, bid, or applicatian I n! I!' lgibfe tn YecelVe #? g sn9clfieei arant. ioar, 0!' jJc Vllle lt alld rknnwyedoes thak thlscontract may be terminated nd ayment v b N rhheld f . tertlfica lon 9s na urate_

I y 4f Oli VOIi' 1

ihe information callected on k? s ^:.^.' 1 vllll4 p ±'? ryaint fl ed y ntpr I nr_.al C; nvgrnmPnt N me , h tiA g rygption, ti pt

r onk tiad n re u s! a , m 4nf rm rf abou! i 18 I farm tion c tlP r? abot, t vov. Ur der atians z, a 9 a^ d ti,+J23 c!

the Tsx s G vernment adA, yau 9154 r? n#[ flec ia r C$! VB c] 7C± r@VIEW ? infnrmS}{ 0;, jn,r ipr ;; ec#iar 5', n44 ;± h

Gavernment Ga s, u !' e 1s0 Pf 4fi[ 1 X 12a/ i;;+^ m ri n a±:ti!# you corrected Cha.t , r„a , P iAv$ Incorrect.

k

l. ._- ' 1`,`,'..,, 1. c. i9130" 2U21

ICIi r EJi' Qata

ichael,. N m1ic;, presid nt

FiintP iVwri

I' iIS PR J GT iS N JOII T V! TURE,

AL. l A iTk S Il} I' .; N { hlTLb!? l 1S i` f'? J1lRr? A G[ 7MPL G' E Or R.

Y' N! s: ?^' E. J'!! Ips 5R7' 5lneprovemcntsipN 1024! I

5 1 [ rn lle en ati Pr ce xres

The followizag requirem.ents are to be followed for this project.

635.108 Health and safety.

Contracts far projects shall include pravisions d signed:

a) To insure full compliance with all applicable Federal, State, and Iacal laws gaverning

safety, healih and anifa ion; and

b) To require that ihe contracto sha.11 provide all safeguards, safety devices, and protectiveequipment and shal.l ta e any other actions reasonably necessary to rotect the 1'rfe andhealth of pexsons working a the site af the pro3ect and the sa ety of the public and toprotect property in coz t ection vvith the perfo ance af the work covered by iYie contract.

CC Moss a d Nll. Phillips SRTS Improvements. CPN ID24-11

rtifl a l n garding hbying

To be submitted with ach bid or offer xce ding $ 10D, Oa0)

The undersigned certif es, #a the b st 9f his or h knawi dg and F efief, hat:

a} No Fede al appropriated funds have been paid or will be paid, bv r on behalf of th

vndersi ned, to any person for inftu n ing 4r tt mpting to influ nee an oificer r mpiay e f !

a ency, a Member of Congress, an offic r ar mployee f !? gress, or an em lay o# a M mber af

gr ss n onnection with ihe w ding of ny Federal Lat iract, th rakin c f any F der l grant, k!+ p ma ing of anv Federal laan, th nt ring fnto of an caaparat ve greement, and th extension,

iantinu tion, renewaE, mendm nt, r ma ification f aruy F r! wnntra t, rant, n r1, r oap ra iv

greemen.

b} f any fu is other h n F Ar! apprQpriat d Fun s i e r paid rw lE a d t any ;i721'5011ior influencing or u+.tempting influen ffic r r empioye f ny ency, a llemb r o Congress,

firpr nr pmp oyee of Congl' SS, r s mnln gg f a MPmhr r f Qn rBgS In r nn ctEon wi#h thisrieral ntract, ran, paan, t r ; n r€tiv re: ment, i!? :„ rsi n d a11 nmplete an + al mit

Standard IForm LL, " 7isclosu e F rm f ep rt Lai ioving, n accor ance r th its instruetiorts,

c T e under$ ianed ;! 6i t uir th t ! Iw; gua e paragrapF 1 nr f hic nt n bvingertification be t cl! d ir t a+! ar+ do umenls or w+! awar ls t a91 ta rs ( including 5ubc ntrac s,

fi11+ gran s, and ontraGts undergr nts, I? s, and cnop rative aare ments) and l h tal c lbracipients1 r, rrtifV 811 icrinca rnrc in.

Q- r;fkcatian s a materiaf pr s nt tit r i' act undn wh ch afiance + vas , 1ar_.c1 ! w n h+s

a sac tinr, w s râ p r e tered fr a, bmis on f dl s certifaca# ior Js prer duisite f r kr king ntering nta thi r nsa tM n ir:±, ase d by 3 ,.::. 1 7 amendr d by t L hhylrig D'!! ns rp

Act of ' I 995}.

h ntractc r, orthstarConstructlon, LL-C { ,;.},

s r afFi mg thfiiYna c nrl rri rar ¢ G

t? l Tl l. Of ; t : er#ifi atic n : t i i in r, 1 I? V. I itin ryF yg ; n±ra_r.tnr nrl* tanria nt rggS

t! t he rovisians + f 31 . 1,_ C. 3 t s c., y to this t fication apd disclosur, if ! Y,

r ; { -

i^'' -_ ` = T ,+' ..'"—

t rr- f ntrar4nr" s Au ariz d Offi ial

Ilnichaei A. - leimlich, i' re ident

G; t d Name and Titla of Contractor' s Ruth ri d ffic l

en eml er 3, n2

e

C R" nsn e nd ; 1- PI;.;! i;, s 5!?5c i•,, prova enteL' 3} N I b24! i

IS C SUR O L 1 YlNl , 7' IVlil Approved by OMB

Complete this form to disciose lobbying activities pursuar t to 39 U. S. C. 1352 0348- 0046

See reverse for ublic burden disalosure. 1. Type f ' ederal Action: 2. Status o# ederal Actlan: 3, Report Type:

a. cohfract a. bidlofferlapplicatian a. initial filingb. grant b. initial award b. material change

c. conperative a reement c. pos#-award or Material Change Onl:

d. laan year quar# ere. loan guarantee date of iast reportf, loan insurance

4. i ame and Address of Repor ing ntity: . lf Repor#ing n ity in Io. 4 is a Subawarde, nter Name

Prime Sudawardee nd Address of Prime:

iier , ifknown;

Northstar Construction, i.LC

2112 Salona Street

Foi t Woi th, Texas 76117

Gon _ ressional Istric#, rfknown: on ressional istric, rfknown: 4c

6. ederal epartmentlAgency. 7. ederal ' rogram NamelDescript on:

Departtt' ant of Transportakian 1 Irene 5treet - Safe Routes to Schoni Iiuprovem nfs

C-FDA Number, lfapplieable; 0902- 50- 125

edeeal AcEion Number, r known: 9. Arnr rd Amounf, lfkrrown:

2, F38, 672. 4U

10, a. Name and Address of 6obbying Registrant b. Indlvlduals erforming Serrrices ( including address rflPindlvldual, lastRame, firsfname, MI: dlfferenf from No. 90a)

f { dasr, r rrre. rs# nar re. M!): N4NS I

111{ OflIYAl1011 Iq ahslnJ I^ elEoh Ih i nn a eii!' IMde i I Ii11H =" u. C. er.r'a,. - rf - 11 c naiure: ' ' . t. _ - _ ..- 1362, Thfe tl1o4 Gea a ul ! ahtryS ecllw','ai la n IR" ti"!" r^ p't"^'"!!^n P1 faGl — upon whlch reAancu was s: 1yK! 7j Ihtr IIBr f Ve w:• i ti„ x Ir: r: sr} iniF , c m_.. d N1+.c:ha l •'. 1 i Q1: 774YC1t0[ BI319ffld 1010. Thlp r! lse raura la • quhatl ;+ xsuam rn '. uy 41. 5 v. 1552. Thu ' i I It I ql'; il fnrmallon Wql BB avalI0U1B Ior puhllc Inspect on. i4ay perean who iaus tn M g np ,

i o } s?( nirequlred tl sclosura sheq be su6jecl fo e civll pen iiy c f r: r s: y ir- n 1^,^.,^ d k^5

nalmvrelhen$ 100,OOOforaechauahfaUure. ' ,$5 a T y n CR rhone ,No.; tt k , - te: _

e eeal k se [ r!!y: Rluthorized tcr Local tepm tivn

andard orrrti LLL ' Rev, 7- 97)

C Mass and ML g: illip,s. iRTS Imp bvenwlltsCP3V ! 02A I I

Nan- Collusian Aitidavit and Debarment Certifieation

PROJECT: CC MOSS AND ML PHILLIPS SRTS IMPROVEMCNTS

HIGHWAY: VA

COUNTY: TARRANT

TXDOT CSS; 0902 9Q 084

INDIVIDUAL DOING BUSINESS i1NDER A FIRM NA11' IE OR FOR A CORPERATION

The 6idder being duly sworn, salemnEy swears ( or affirms} that rieither h, nor any of cial, aget t : employee has ettter$ d into any agraement, participated in any callwsion, ar Qtherwise taken any actioi which is in restraint of free corrtgetitive bidding in connecfion with any bid or contraet, and #ha# the bidderintends to do the work with k is awn bonafide employees or subcantractars and will not bid for the benefitaf another contractor,

By submi fing this naneCOIIllSlbri afFl( aVil, fN' :''! ntrar_.tn i5 C Ci?? I11 Ii1S 5tt3t! 5 k!'! C'?' a tlaltV Of y PjllY' yunder the laws of the United States in accordance wit3t the Ph nn nt G tifi ti n ;;+'tw hed, ¢ rovided

that the Debaf•me t Cex•tifcateon also inciudes any required slatements ccri ce r,i„ g t pntian si at r

applicable.

SIGNATURE OF BIDDER

Name af Bidder : Michaef A. Heimlich

Print Qr type indsvidual name

Trading and doing bus ness as Northstar Consiruction, L CPrint or type rm name

21 2 Salona Street, ort Worth, Texas 76117i.• p . u s., , . I

ti a y • .

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W#,:, c 5ignature of Bidder, [ ndividually

Ll` 3 5 , - f m1_r.4

Fl f: t ('': V} 7 i } iMnPy" nr117h ^•

1IICh I f. Qimlir.i, I C iCieflt

3: d o* wne signer' s atti t

f a +' v:'nnr gjUr] 3 tjX {."QYpO' tC Sea

A1'+F Y] AV rT rtt.c r uR 1T i2Y7. F.

11T TA' ' GE4L

5ubsarlb d and sworn ta L, fn thi r, ( ltl, r ay c: f temb rt, 0 1,

c! ay f h- y

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i; atur c Nnrar u u"c '

45x5 iil.' r' ir ` i# i f i f: f', :

t+l9[ qry ? U1 Ii+, S Ta it t xoA

4" i,' i 4nim, x[ s4re5 f19 75-+ j 1

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e a par ment of T an po f ien

iNSTRUCTIONS

BE ORE YOU SIJBf iT THIS FORfiA, 14IiAKE SURE:

Form 1560- CS

PrnFessional Pro ider lnsurance

Rev. q3l13)

Page 1 of 2

Previously Knpwn As Form i560- CSS)

You have tF e mast current 1560- CS TxDOT form. Go to th following TxDOT Internet site: httn•.f ryww.txdot.qo ibuslnesslconsultantslinsurance. f tml th n look for the ' orm 9560-CS.

o Ynu have entered the 1- digit Vendor ldentification Number, which includes your nine- digit FE[ N { F deral EmployerIdentification Number).

You have entered each authorized agent' s comple# acidress, teiephone numb r, policy expiration dates, sign and date. lf more than ane agent covers difFerent types of insurance ( one writes Workers' Compensatian, but anather writes

Auta), hoth have issued the ceriificate in its entirety. 6 You have provided all r quest d information on the forms, which may be faxed but must be foflowed up rvith the

originally signed forms to the address listed below. e The farm is being submikted in connection wiih a professional services contract.

For construction and maintenance contracts, go to the fallowing TxDOT Internet si e: ht; LLldpme+ t lo qavLbu ill S then look for the Form 1560.

DO NOT COMPLET THIS FORM UNL SS WORIiERS' CDMPENSATION 15 ENAORSED WITH A WAIVER DF

SUBROGATION IN FAVOR OF TxDDT.

Tn a oid work suspension, an upciated insurance form mus# reach the address f'rsted i elow one business dayprfor to the expirat an date. List the contractor' s legal company name, including th BA ( doing business as) nameas fhe insured. If a staff leasing service company is providing insurance, th staff leasing company name is s ownfirsf as the named insured and then in parenthesis iderttify the contractorlclie t co npany ( i. e. XYZ Staff 4 U, Inc.- sfaffleasing service company ( ABC Engineering, Inc.)). Show contact information ( i. e. address, phan number, and etc.)

for th insuredlstaf# leasing service company in the appropriate spaces. Show the contact inforrr3ation ( i. e. address, phone number, and etc,) for the contrac orlcl ent company in fhe appropriate spaces. The certificate of insuranc, ance an file with the department, is adequafe for subsequent depar ment cantracts provided adequate coverag is stillin effect. o not refer to specific projects or contracts on this farm. Dver- sfamping or o er- ryping entries on thecertificate of insurance are r ot acceptable if they change the provisions of the c rtificafie in any manner. Stamped,

typed, or printed signatures are not acceptable. Pre-printed limits are the minimum required; if higher lim ts arepra ided by the policy, enter the highe fimit amou t and strike through or cross out the pre- printed limit. Binder

numbers are not acceptable for policy numbers.

WORKERS` CONYPEiVSAT OiV INSURANC:

The contractar is required to have Workers' Compensation Insurance if the contractor has any employees, incEudingrelatives. The ward STATUTORY, under limits of liability, means that the insurer wauld pay benefits allowed under theTexas Work rs' Compensation Law. GROUP HEALTH or ACCIDENT INSURANCE is not an acceptable substitute for

Worfcers' Compensation.

COl ffi I RCIAL GEN RAL LIABIL[TY IWSURANCE:

If co erages are specifed separately, ihey must be at {east these amounfs;

Bodily lnjury $ 500,000 each occurrenc

Property Damage $ 100, 000 each occurrence

100, D00 for aggregate

MANUFACTURERS' or CONTRACTOR LIABILfTY [ NSURANCE is nat an acceptab e substitufie

for Comprehensi e General Liability Insurance or Commercial General Liability Insurance.

Bus N ss au ro oBi E o cY:

The coverage amount for a Business Automabile Policy may be shown as a minimum of $600,000 Combined 5ingleLimit by a typ d or printed entry and deletion of the specific amounfs Eisted for Bodily Injury and Property Damage. Personal Automobile Liability Insurance is not an acce table substitute for a Business Automobile Poficy.

ii AIL C RTIFICATES TO: Texas Depa tm nt of Transpnrtation

Canteact 5ervices Office

a°j . ky t. CC Moss and Ivtl, l'hillips SI2T' S Improvements

Austin, TX 78701 483CPN i02411

1 416-4620 ( V) 1- 416- 46 1 ( F)

ex s p r men o T'r n por tion ( TxDOT) d++,„ ii ic/4 o i u, a

Form 156- CS

Professional Provider insuranceRe. 03113)

Page 2 of 2

Previously Known As Fnrm i5BQ- CSS)

7his ceriificate of insurance is pravided for informational purposes onEy. This certifcate does not confer any rights vr obligations other than the rights andobligatio s conveyed by #he policies referenced ar #his certificate. The ferms of #he referenced policies eontrol over the terms of this certificate.

Prior to the beginning of work, the Conlractor shall obtain the minim am insurance and endorsemenfs specified. Dnly the TxDOT cerfifrcate of insurance formis acceptable as proof of insurance for department conlracts. P ents should complete the form providing all requested information then either fax or mai] fhisform direci{ y to the address listed on page ane of lhis farm. Copies of endorsements listed beiow are not r quired as attachments to this cerfificate,

nsured:

StreetlMailing Address:

City:

Phone Number:

ConfractorlClient ( if applicable):

Street/Mailing Address:

City:

Phone Number:

1Norkers' Compensation Insupance Covepage: Endorsed with a Waiver of Subrogaiion in fa or of 7xDDT.

State:

Vendor ID I umber ( 1 digits):

State:

Vendor ID Number { 11 digits}:

Zip Code:

Zip Coda;

Carrier Name: Carrier Phone Number:

Address: City: Stat: Zip:

7ype of Insurance Palicy [ umber Effective Date Expiration Qate Limits of Liability

Workers' Compensafion Not Less Than: Statutory - Texas

Commepcial Gene af Liabi[ ifiy [ nsu ance:

Carrier Name: Carrier Phone Number;

Address: Giiy: State: zi:

Type of ]nsurance Pqlicy Number Effective date Expirati n Date Limits of Liability

Commercial General Not Less 7han:

Liability Inst ranc Sodily Injury $

500, 000 each occurrence

Praperty Damage $ 100, 000 each occurrence

pR $1 0, 000 for aggregate

Commerc9al General R

Liabiliiy Insurance $ 600, 000 combined single limit

Automabile Liabilify lnsurance;

Carrier Name: Carrier Phone Number;

Address: Cify: State: Zip:

Type of Insurance Policy Number EfFeciive Date F cpirafion Date l.imits of Liability

Business Ai.ttomobile Policy Not Less 7han:

Badiiy Injury $ 250, 000 each persan500, 000 each occurrence

Property Damage $ 100, 000 each occurrence

u hori ed Agent name, address and z p code:

TH15 iS TO GERTIFY to the 7exas epartmenf of Transportalian acting on behafi of the 5tale of Texas that fhe insurance policies named are in full force and eifecL ! tthis form is sent by facsimi e machine ( fax), iha sender adopts the document received 6y Txb07 as a duplicate original and adopts the signatur prodwced by therecerving fax machine as the sender' s onginal srgr ature.

The Texas Departmenf of Transportation mainfains tf e information coltected thraugh this form. th few exceptions, you are entitled on request to be iniormed ahouttk e information that we collect about yau, Under sections 555. 021 and 553. 023 nf the 7exas Govemment Cocfe, you also are entltled to recefve and review theinformation. Undersection 559, OQ4 of the Government Cade, you are also erttiiled to have us correet informaiian aboutyou that is incorrect.

Area Code ( )

Authorized Agent' s Phone Number Origina Signature of AuEhorized Agent Date

CC Moss and ML Phillips S1ZTS Tmprave net ts

CPN 102411

idder Cert[ fica ion

By signir g the proposal the bidder certifies:

1. the only persans or parties interested in this proposal are those named and thebidder has nat directly or indirectly participated in collusion, er tered inta ar agreement or otherwise taken any action in estraint of fre comp titi e biddingn conn ction with the abo e captioned project.

2, in the e ent of the award of a cantract, the organizatian represented will secure

f onds for the full amount of the contract.

3. the signatory repres nts and warrants that they are an aUthorized signatory forthe organization for which ihe bid is submitted and they ha e full and eompieteautha' ity to submit this bid on beha[ f of th ir firm.

4, that the certifications and representations contained in the praposal are tr e andaccurate and the bidder intends the proposa[ to be Caken as a genuinegovernment record.

CC Moss attd MI. Pltillips SRTS Impravements

CPN 1024ll

E

Subconfracts-Federaj Aid Projecfis)

By sigr ing this proposal the contractor is gi ing assurances that all subcantract

agreements af $ 1, U00 or more an this project will incorporate the following:

Sp cial Provision

Special Pravisian

Special Provisian

Form FHWA 1273

Applicahle

Certi catian af No discrimination in Employment"

Natice af Requirement for AFfirmative Action to Ensure Equaf

Employment Opportunity" ( Executrt e Order 91246)

Standard Federal qual Employmen# Opport nity Constructian

Contract Specifications" { Executi e Order 9 24fi)

Required Gantrack Provisions Fede' al- aid Construction Contracts"

Form FHWA ' l273 must also be physicaCly attached tn subcantracts

and purchas orders of $ 10, 000 or more)

Wage Determination Decision"

Alsn, by signing this praposal the cantractor is gir ing assurances tf at all su6contract

agreements will incorPorate the Standard Specifcation and Sp cial Pro isions.

CC Moss and ML Phillips 3RTS Improvements

CPN 1U2411

CSJ: 0902- 90- 084

Project: STP 202( 069} TP

Connty: TARRANT

ENGINEER 5EAL

The enclased Texas Department of

Transportation Specifications, Special

Speci catians, Special Provisions, General Notes

and Specification Data in this docume ut have

been selected by me, or under my respansiblesuger isio as being applicable to his project. Alterafion af a sealed document wifhout properNotification ta the responsible engineer is an

Offence under the Texas Engineering Practice.

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P,Eo OF

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qoSCOTTeR P ARNO eDeO 0 e, 9fi782 poW 0, 5. 1

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CC Moss and ML Phillips SRTS I nprovementsCPN ! 0241 I

8 3 zoza

Gen8ral eCisinn Num6er: TX20200626 03/ 13/ 202E

Superseded General ecision Num6er: TX20S96926

State: Texas

Constru tion Type: Heavy

Counties: Johnsart, Parker and Ta rant CauqCies in Texas.

Heavy Const uctiort projects ( Including Water and 5ewer Lines)

kote: lJnder Executi e Order ( ED) 13658, art houriy minimum wageof $ 10, 80 for calendar year 2020 applies to all cantractssabject ta the Uavis- Bacon Act for which the tontract 3s

awarded ( and any solicitation was issued) on or after 7anuary1, 2015. if this con ract is covered by the Eo, the cnntractormust pay all workers in any classificatian listed an this wagedetarmination at Ieas' C $ 16, 80 per hour ( ar the applicable wagerate listed on this wage determi. nation, if i.t i.s hzgher} for

aIJ. hnurs spen' perfarming on the rontract in calendar year2020. T this cantract is covered by the EU and ac}. assi# icatian considered necessary for performance of work onthe contract does not appear on this wage determination, the

contractor must pay workers in that classificatian at least thewage rate determined through Che conformxnce process set orthin 29 CFR 5. 5( a)( 1)( ii) {nr the EO minimum wage I^ ate, if it shigher than the conformed wage rate). The EO minimum wage rate

wiil be adjusted annually. Please nate that this EO applies ta

the abave- mentioned types of contracts entered into by thefederal government that are suhject ta the Dav35- Bacon Actitself, but it does not apply to cantracts subject anly to thePavis- Bacon Rel.ated Acts, including those set -Farth at 29 CPR5. 1( a)( 2)-( s0). Additianal info.rmatian on contractor

requirements and worker protectinns under the Eo is evaiJ. ableat www. dol. gov/ wE d/ govcontracts.

Modiflcation Number Puhlication Oate

0 01/ 03/ 2829

1 03/ 13/ 2020

PLUM0146- 082 11/ 01/ 2619

Rates Pringes

PLUMBER/ PIPEFITTER ...............$ 32. 53 9. 50

SUT1C1990- 941 06/ 01/ 1990

Rates

CARPENTfR............ .............$ 16. 40

Cancrete Finishel^ ................$ 4. 81

ELEC7RICI1IN ......................$ 13. 26

Farm Setter ......................$ 7. 85

aborers:

Common ......................$ 7. 25

Lltility ......................$ 8. 99

PAINTER ..........................$ 10. 89

Pipelayer ........................$ 8. 43

Power equipment operatars:

saCkhoe...........•-•••••...$ 11. 8s

sulldozer ...................$ 7.9. 76

Crane .......................$ 13. 16

Front End Loader............$ IB. 54

Mechanlc ....................$ 19. 93

Scraper .....................$ 1.0. 99

Fringes

3. 64

3. 38

3. 38

Reinforcing Steel Setter.........$ 20. 64

TRUCK pRIVER .....................$ 7, 34

WELaERS - Receive rate prescribed far craft perfprmzngoperation to which weldfng is incidental.

Note: Executi e Order ( EO) 13706, Establ. ishzng Pai.d SicK Lea efor Federal [ ontractors applies to all contracts subject to the

Uavis- Ba on Act for which the tontratt is awarded ( and anysolicitation was issued) an or after 7anuary 1, 2017. If this

contract is cavered hy the R, the cnntractar must prqv9. deemplayees with 1 hour of paid sick Ieave for every 30 hoursthey worK, up ta 56 hours of paid sick leave each year. Emplayees must he permitted to use paid sick lea e for theirown iilness, injury ar other health- related needs, includfngpreventive care; to assist a family member ( or person who is

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8/3/ 2020

li.ke family to the emplayee) who is i11, injured, or has otherhealth- related needs, includirtg preventive care; or far reasonsresult3ng from, or ta assist a family member ( or person who islike farrtily to the employee) who is a victim of, damesticviolence, sexual assault, or stalking. Additional infarmatian

on contractor requirements and worker pratecti. ons under the E is a axlable at www. dol. go/ whd/ gov€ ontracts.

lJnlisted classi ications needed for wark not included withinthe scnpe of the classifications listed may he added afteraward only as provzded in the labar standards confract clauses

29CFR 5. 5 ( a) ( 1) ( ii)}.

7he body of each wage determination lists the classificatianand wage rates that have been found to he prevailing far theci ed type( s) af construction in the area cvvered by the wagedetermination. The tlassifi wtians are listed in a] phabeti. calarder of "" identifiers"" that indicate whether the particularCate 3S a union ra e ( Current union negotiated rake for local),

a survey rate ( weighted average rate) pr a¢ nfon average rateweighted union average rate).

Union Rate Identifiers

A our letter classi Fication abbreviatr. on identi' ier enclosed

in dotted Iines beginning with characters ather than "" SLi"" or

UAVG"" denotes that the unipn classification and rate were

pre ailing for that classifi ation in the survey. Example: PLl1MB198- 085 07/ 91J2814. PLl7M is an ahbreviation identifier nfithe union which prevailed in the sarvey far thisclassification, which 1n this example would he P1umBers. 8196indicates the local union nUmher or district eouncil numi arwhere applicable, i.e., Plumbers Lacal 0198. The next number,

005 S. n he example, s an internal number used 3n processzngthe wage determinatinn. 97/ 1/ 2014 is the effective date of the

mos' C current negotiated rate, which in this example 3s 7uly 1, ae a.

Union preva3]. ing wage rates are updated to refleci aJ. l ratechanges in the eollective 6argaining agreement ([ BA) governingtFris classificaCion and rare,

Sur ey Rate Ider tifiers

Classifications listed ¢ nder the "" SU"" identifier indicate that

no ane rate pre ailed far tih s classification in the survey andthe published rate is deriued 6y computing a weigitted averagerafe based on aYl the rates reported in the survey for tha'Cclassification. As this weighted average rate includes all

rates reported in the survey, it may include both union andnon- union rates. Example: SULA2012- 007 5/ 13/ 2814. SiJ indicates

the rates are survey rates hased on a weighted averagecalcula ion of rates and are not majorfty rates. LA indatatestSne State mF Louisiana, 2012 is the ysar a-F survey on whichthese classifications and rates are based. The next number, 007

in the example, is an in'CernaJ number used in producing thewage determination. 5/ 13/ 2014 indicates ihe survey completinndate far the cJassif ations and rates under that identi. fi.er.

Survey wege rates are not updated and remai, n in effect until anew survey is conducted.

IJnion Average Rate dantifiers

Classification( s) Iisted under the UAVG ident3fier 3ndicate

that na single majority rate pre ailed far thoseclassifications; howeuer, 109% of the data reported for the

classi Fications was uni.on data. EXAMPLE: IIAVG- OH- 0010

08/ 29/ 2014. UAVG indicates that the rate is a weighted unian

average rate. OH indicates the state. The next number, 0@19 fn

the example, is an internal number used in produciRg the wagedetermination. 06/ 29/ 2014 lndicates the survey campletion datefor the classifications and rates under that identifier.

A UAVG rate wi11 he updated once a year, usually in 7anuary ofeach year, to reflect a weighted average of the currentnegot4ated/ CBA rate af # he union locals from which the rate is

hased.

WAGE ETEHMINAIZ N APPEALS PROCE55

1.} Has there heen an initial dedsion in the matter? This canbe: •

an existing published wage determinationa survey underly ng 2 wage determinationa Wage and Hour Di ision letter setting forth a pasitian ona wage determsnation ma ter

a conformance ( additional classifiication a d rate) ruling

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CC Moss and ML Pl il[ips SRTS Improvements

CYN I02411

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813l2020

On survey related matters, fnitial contact, includirtg requestsfor summaries of sarveys, should Ge with the Wage and 11ourRegional Offite for the area in which the survey was conductedbecause thase Regianal Offices have resp.onsibility far theavis- Bacon survey program. I-F the response ram thls initial

contact 3s not satisfactory, then the process descrihed in 2.) and 3.) shauld be followed.

With regard to any other matter not yet ripe for the formalprocess descri.6ed here, initial contact should be w3th theBrench of Construction Wage eterminations. Write to:

Branch of Canstruction Wage ueterminations

Wage and Haut' DivisianU. S. pepartment of La6or

208 Constitutinn Aaenue, h1. W.

Washington, UC 262I9

2.) I he answer to the question in 1.} is yes, then aninterested party ( those affected by the action) can hequestreview and reconsiderat on from the 4lage and Hour Administratar5ee 29 CpH Part 1. 8 and 29 CPR Part 7). Write to:

Wage and Hour Admznistrator

U. S. bepartment af Labor200 Cons# itlrtSon Avenue, N. W.

Washingtan, DC 2e210

The request should he accompanied by a full stetement af theinterested party' s position and by any information ( wagepayment data, prpject description, area practice material, etc.) that the requestnr cnnsiders relevant to the issue.

3.) If the decisian of the Administrator is not favorable, an

interested par' y may appeal di. rectly to the Administrati eReview eoard ( formerly the Wage Appeals eoard). Write to:

Adminzstrative Review BaardU. S. oepartmen' t of Labar

200 Constitutian Avenue, N. W. 4lashington, oC 20210

4.) All decisions by ihe Administrative Review Board are final.

ENb OF GENERAL ECISION"

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CC Mass and NII. Phillips SRTS I nprove nents

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I r s Prodlu cedl l I. e° i s

635.4I7 Convict produced materials.

a) Mat rials praduced after ruly 1, I991, by convict labor may only be incorporated ixz aFederal-aid highway co nsirnction pro ect if such matexials have been:

1} Produced by canvictis who are on parole,' supeivised release, or probation fiom apr son or

2} Produced in a qualified pri on faciliiy and ie cumulative annual production amountofsuch m terials fox use in Federal-aid highway construction does not exceed theamount of such matez ials praduced in such facility for use in Federal-aid l ghwayconstruction during the 12- znoz th periad ending uly 1, 1987.

b) Qualified prison faciliiy means any prz on facility in which convicts, during tk e 12- monthperiad ending July 1, 1987, produced materials for use in Federal- aid highway constt tciionprojects.

CC Moss and NII. Pltillips SRTS Improve entsCPN I02411

i ri S e C' rnd ti ns

a) Except as provided in paragraph ( 6J af this section, the fallowing changed conditions contractclauses shall be made part of, and incorparated in, each highway eonstruction project approvedunder 23 U. S. C. 106.

2} iffering site condrtFons.

i) During the progre$ s of the work, if subsurface ar latent physical conditidns are

encountered at the site cEiffering materially from those indicated in the contract or if

unknown physical conditions of an unusual nature, difFering materially from t aseordinarily encountered and generally recognized as inherent in the work pro ided for in

the contract, are enco nterecl at the site, the party disco ering such conditions sha[ I

promptly notify the other party in writing of ihe specifc differing conditions before ihe

site is disturbed and before the affected work i performed.

iij Upon written notificatian, the er gineer will inve5ltigate the canditians, and if it is

determined tf at the conditians materially differ and cause an increase or cfecrease in

the cost or time required far the perforrr ance af any work under the contract, an

adjustment, excluding anticipated prafits, will be made and the cantract modified in

writing accordingly. The engineer will notify the cantractor of the determinationwhether or not an adjustrnent of the contract is warranted.

iiij 3o contract adjustment which results in a benefit to the contractor will be allowedunless the contractor has pro ided the required written notice.

i} No contract adjustmertt will I e a l owed under this clause for any effects caused on

unchanged work. (This pro isian unay be omitted by the sTD' s at their option.)

2) 5uspensions of work ordered 6}r the engineer.

j Fi he performai ee I or any p rti n of zhe work is spended or deiayed y the

ragineer in writing for an ut reasonable period of time ( not origiRally anticipated,

r ustorr7ary, c r unherent ta * h canstruction u dustrv) and h contractor believ s thata ditional compensation and/ or contract time is due as a resuit of such suspension or

de! v, th . n rar or yF a] I submii ka *! r?? Pngineer in writing a request for adjustment

U! ithin 7 calendar days of receipt r f the r otice to resurne work. The request shall set

h thP rPaspr s I d Support or' SUCh djustl lEl1t.

iiti pon re eipt, the engirieer Y ill evaluate the cantractar' s r? est. If the ? gsneer agrees

th•.at the cost nd/ or time rec uired far the performance of the contract Cnas increased as

a r sult of such suspension and the suspension was caused by condifian5 beyand the

untmi nf and nnt the fault of the contractor, its supp[ iers, or subcontracfiors at anv

appro ed tier, and ot caus d by vPather, the engine r will rr ake ai adjustment

M ss and MI_ !'hilli s SR` F' S Impravemen s

k N 1U2411

excluding profitJ and modify the contract in writing actordingly. The cantractor will benotified of the engineer' s determination whether or not an adjustment of the contract is

warranted,

iii) No contract adjustment will be allowed unless the contractor has submitted the request

for adjustment within the time prescribed.

iv) No contract adjustment will be allowed uRder this clause to the extent that

erformanc wauld ha e been suspended or delayed by any other cause, or for which

an adjustment is provided or excluded under any other t rm or condition of thiscontract.

3J Signifitant changes in the chcrracter of work.

i) The engineer reserves #he right to make, in writing, at any time during ti e work, such

changes in quantities and such alteratians in the work as are necessary to satisfactorily

complete the project. Such c anges in quantities and alterations shall nat in alidate the

contract nar release tE e surety, and the contractor agrees to per arm the work asaltered.

iij If the alterations or changes 9n quantities significantly change the character of the workunder the cantract, whether such altera ians or changes are in themsel es significant

changes ta ihe character af the work ar by a fecting other work cause such other work

to become significantly difFerent in character, ar adjustment, excluding anticipated

profit, wili he made to t e contract. The basis # or the adjustment shall be agreed upan

prior to the performance of the work. If a basis cannot be agreed upon, then anadjustment will be made eitherfor ar against t e contractor ir such amount as the

engineer may determine to be fair and equitabl,

iii} Ifthe alteratio s or changes in quantities do nat significantly change the character of

the work to be perfarmed und r the contract, the altered work will be paid for asprovided eEsewhere in the contract.

ivJ The term " significant cf ange" shall foe construed to apply onlyto the followingcircumstances:

A) When th character of the work as altered differs rrmaterially in kind or na ure from

that invol ed or included in the original proposecE construction; or

Bj When a major item fwork, as defined elsewhere in the contract, is increased in

excess of 125 percent or decreased elow 75 percent of the origina! contract

quantity. Any allowance for an increase in quantity shall apply only to that portion in

excess of 125 percent of original contract item quantity, or in case of a deerease

below 75 percent, to the actual amaunt af worlc performed.

GC Moss and MI. Pl; illips SRTS ImprovementsCPN I02411

b) The pro isions of this section shall be go erned by the following:

1) Where State statute does not permit one or mare a# the contract clauses included in

paragraph ( a) of this section, the State statute shall prevail and such clause or clauses neednot be made applicable to Federal- aid highway contracts.

2) Where the State transpartation department has developed and implemented one or more

of the cdntract clauses inclucEed in paragraph ( a) of this secfiion, such clause or clauses, as

de eloped by the State transporCation department may he included in Federal- aid highwaycontracts in lieu ofthe eorresponding clause or clauses in paragraph ( a) of this section. The

State' s action must e pursuant to a specific State statute requiring differing contractconditians clauses. Such State developed. clause or clat ses, howe er, must be in

confiormance with 23 U. S. C., 23 CFR and other applicable Federal statutes and regulatians as

appropriate and shall be subject to the Di ision Administrator' s appro al as part of the

f' S8eE.

c) In the case of a design- build project, STDs are strongly encouraged to use " sus ensions of work

ordered by the engineer" clauses, and may consider " differing site condition" cfauses andsignificant changes in the character of wor[c" clauses which are appropriate far the risk and

res onsibilitiesthat are shared with the design- builder.

CC 14' f0,. 5 W7d hi- P;,.!?; 5 ;":;; : S;, n rnvementsi-1' N I L? 41 i

Project Numb r: STP 2022( 069} T'

County: TARRANT

H'rghway: VA

Sheet A

Control: 0902- 94-084

Specification Data

Basis of Estimate

Iiem Descri tion

165 FertiXizer ( l 6- S- S)

168 Vegetat ve Watering

Non- Pay, for Can tractor' s Informatznn . ly.

Rate

6001./ acre* *

169,400 gal.facre

Unit

ton

1, OOD gal.

Single Iane`closuxes, except a otherwise shovdn in the lazas, w il be xeslxicted to offpeak hoursas defined in the following table:

Peak Hours Off-1' eak Hours

7 to 9 AM 4 to 6 PM 9 AM to 4 PM Ail day Satt urdayMonday through Monday through and and SundayFriday k'riday 6 PM to 7 AM

Monday throughFrida

Existing storm sewers and utilit es are shown from the best available i formation. Vexiiy thelocation of all undergraund facilities prior to starting work.

General Notes

CC Moss anci ML Phiflips SRTS ImprovementsCPiV 102411

Project Numberc TP 2022{ 069) TP

Caunty: TARRANT

Highw y: VA

Sheet B

Control: 0902- 9- Q$ 4

The olla ring Holiday/ Event lane closure restrictian requir ments apply to this proj eci: Na work that restricts or interf r s with traffic shall be allowed between 3 PM on the daypreceding a Holiday or Event az d 9 AM on the day after the Holiday ar Event.

Haliday Lane Clasure RestrictionsNew Ycar' s Eve and New Year' s D y 3 PM December 30 through 9 AM January 2December 3l. thraugh January 1)

Eas er Holiday Weekend { Friday through 3PM Thursday through 9 AM MondaySundayMemorial Day Weekend ( Friday through 3 PM '1` ursday through 9 AM Tuesda Mo dayIndependemce Day (] u1y 3 hrough July 5) 3 PM Juiy 2 through 9 AM July 6

Labor Day Weekend ( Friday through 3 PM Tliursday through 9 AM TuesdayMonday) Thanksgiving Holiday ( Wednesday through 3 PM Tuesday through 9 AM Mand:ay

undaY)

Christmas Holiday ( December 23 tl ough 3 PM December 22 throug 9 AM DecemberDeeember 26) 27

Plan work schedules araund the appropriate dates above to ensure productive work is per ormedwithout lane clasures.

Modificahons to Lane Glosurc 1 Wark Restrictions:

Submit a request in writing for appro val by th Engineer a minunuzn of 10 days in advance ofimpl menting a cha n.ge to laa e closure xest ictzons.

When deenzed necessary, the Engineer wil iengthen, shorten, or otherwise n odify lane closurerestrzctions as raffic conditions warrani.

i n deemed neces aty, th Engineer will modify the list of major events when n w eventsdevelop, existing events are xescheduled, ox when warranted.

Special Evants/ Special Siivations will be handled on a ca e- by-case basis. No work resirictinglane closures is allo ved from 3 PM a da before to 9 AM tk e day after the Specia.l Event arSpecial Situation.

General Notes

CC Moss and ML Phii[ ips SRTS Improvements

CPN 10241' i

Project Number: STP 2022( 069) TP

County: TARRANT

Highway: VA

Sheet C

Conirol: 0902-9- 08A

Prevention o Mi ratory Bird Nesfin

It is anticipated that rrugratory birds, a protected group of species, may try to nest on bridges, culverts, vegetation, or gravel substrate, at any time of the year. The preferred nesting season formig ratory birds is from Februazy 1S through ciobex 1. V henpxactacable, schedule construction

operaiions outside n fhe preferred nesting season. Oiherwise, avoid nests containing migratoiybirds and perform no work in the nesting areas until ihe young irds have fledged.

Sf uctures

Do not begin bridge and culvert constructiox operatzons unfiil swallow nesting preven ion isimplemented, until after October I if it' s determined that s allow nesting is actively occur ring, or until it' s determined swallow nests have been abandoned. If the State installed nesiingdeterrent on the bridges and culverYs, maintain tlie e sting nesting deterrent to prevent swallownesting until ctober 1 or completian af he bridge and cuivert woxk, whichever occurs Earlier.

If new nesis are built and accupied a er the beginning of the work, do not perform woxk fihat caninterfere wiih or discourage swailows frorn returning to their nests. Pre ention af swallow

nesting can be performed by ane o' the folla ring methods:

1. By February 1 S begin the removal af any existing mud nests and all other rnud placed byswallows for the construction of nests on any ortion of the bridge and culverts. The Engineerwill inspect the bridges and culverts for nest b zilding activity. If swallows begin nest building, scrape ar v,ash down alI nest sites. Perform these acti vities daily unless the Engineer deterrninestlie need to do this work rnore frequently. Remove nests and mud thraugh October 1 ar untilbridge and culvert construction o erai ons are completed.

2. By February 15 place a. nesting deterrent ( which prevents access to he bridge and culvert b swailows) on the en ire b zdge ( except deck anc railing) and culverts.

No e tension of time or compensation payment will be gra t d for a delay or suspensian of worl caused by nesting swallows. Tlus work is subsidiary to the variaus bid iterns.

The Ca tractor' s attention is directed to the fal awing list of temparary easemerits and theirexpiration dates:

Paxcel Number Expixation Date

Not : The finai list of te nporary easements are yet to be finalized.

Complete all war1 in these easexnent areas prior ta the expi ration dates shown. In the event thatvork is done after these expiration dates, all costs for e ending these dates will be paad hy theCantractor.

General Nfltes

CC Moss and ML Phiilips SRTS Impro ements

CPN 1D2491

Projeet Number: STP 2022( flC 9} TP

County: TARR.ANT

Highway: VA

Sheet D

Control: 0902- 90- 084

Rerriove aIl existing fenc s within tlae right of way and remove and z eplace alI existing fenceswithin easements where such fences conflict with the work. Prptect the remaining fence frorridasx age due ta slacking. Erect temporary fencing zn fihe ease aenfi areas as necessary ta securethe praperty. Pro ide at least one week notice to the property own r prior to removi z g orreiocating the fence. Restoxe p rma. eni fencing to an equal or better condition.

Mail bax manipulaiion made necessary because oF construction will be in accordance wiih YtemS6Q " Ma.ilba z Assemblies," except hat this work r ri11 not be paid £ r di.rectly but will subsidiaryio the pertinent bid iterns.

Provide a11- weather urface or temporary ingress and egress to adjacent proparty, as direcied. Materials, labor, equipment and incidentals necessary io pro ide temporary ing,ress and egresswill not b paid for directly but will be subsidiary to the various bid items,

Where necessary, the gove vng slope indicated herein may be varied from the Iimits sho vn, tothe extent approved.

On superelevated cur es the sboulders uill have the same cross- slope as th pavemeni, UIlIESSatherwise indicat. d.

On superelevated curves where the grade line is in a sag or on a flat grade, overlay the shouldexsto ihe extent nece, azy ta prevent trapping of water on the high side.

AlI driveway openings wiIl ba determined by the Engineer and will conform with TexasDepartment of Transportation " Regulations far• Access Driveways to State Highways" adopted

September 1953, and revised June 2004.

Locations and le gths of all private entrances are approximaie only. The actual locations,

lengths, lines, and grades are ta be esta Iished in the field.

Locatians and Iengths of all pxivate entrances are approximate only. The actual Ioca ions,

lengths, Iines and grades ar to be deterrxiined by ihe Engineer and sha11 cpn oz x. to theregulations of The City of Fort Worih.

Do not discolor ar damage existzng curb and curb and gutter during construction ap rat ons. Inthe e vent of discoloraiion or damage, cl an or repair as directed.

Remove the grass fiam the crown of shoulders or pavement edges by blading ar oiher approvedmethods. Payznent for this rvork will not be z aade directly but will be subsidiary to the ariaus

items of i e coniract.

General Notes

CC Mass and ML Phillips SF2TS Impro ements

CPN 1024N 9

Project Numbcr: STP 2022( 069} TP

County: TARRANT

Highw y: VA

S ee E

Contrai: 0902- 90- 084

The City wi11 perform certain preliminaxy work and will complete ihe work in such sequence andmanner that the Contraeior will be able to begin his woxk at the specified tirne.

The State will perform certain reliminary wark and will complete the work in such sequeneeand manner tha the Cantraetor vvill be able to begin his work at the specified time.

It m 8. Prosecutior and Pro ress

Working days wiI1 be computed and charged in accordance with Article 8. 3. 1. 5, ` Calendar Day.'

Item 104. Preparing Ri ht of Way

Meas rrement far this item wi11 be alo g the centerline af the project witl the Iimits ofmeasurements as shown on the plans.

Item 1. Remaving Treated and Untrea#ed Base and Asphalt Pavement

C ment, lime, and/ or lime fly-ash tt eated laase material removed on thi.s project wiil become theproperty ofthe Contractor.

Item 110. Egcavafion

Review prapased was te sites to detertnine if any site is located in a` Base Flaodplain" or

Floodway" as defined by the Federal Emergency Management Agenc ( FEMA).

If waste material from this project is placed in a base floadplain as defined by FEMA, obtain apermifi rom the local community responsible fo;r enforcing Natianal Flood Iusurance ProgxamNFIP) regulations. Ensure that the owner of the property rec.eiving the waste has obtained the

nec ssary permit.

I em 161. Coznpbst

Plaee approxiinately 4" of compost manufactured topsoil { CMT) on a11 cut and fll slopes ( exceptdrainage channels where flexzble channel liners are i.z. dzcated), at otk er locatians shown on the

plaa s, or as directed.

Gen ral Notes

CC Moss a d ML Phillips SRTS Improvements

CPN '[ 02411

Project Nurnber: STP 2022( 069} TP

County: TA ZANT

Highway: VA

Item 162. Sodding for Erasion Contral

Sheet F

Control: 0902 9Q Q84

Furnish and plac Bermudagrass sod. To obtaiz an. esiimat on quantities, it was assumed to

replace 3' of sod on eifher side afthe propased sidewallc.

Item 1G8. Vegetative Watering

Furnish and install an approved xain gauge at thE project sifi, as directed. Furnishing andinstallation of the rain gauge will not be paid %r directly but wi11 be subsidia y to Item 1b8.

Apply vegetative watering or an establishment period o£ thirteen weeks ollowiz g application ofs ed or installation af sod, at a rate of 112 inc of water depth per week ( approxi_mately 13, 030gallans per acre). During th first four weeks after seeding, apply waier twice per week, on non- consecutive days, each at ha f the weekly application raie. For th rema. inder of the

esiablishment period, appl vegetative watering once per week duriug the monfik s o 7anuarythrough June or September th rougk December, at the weekly appIication rate; apply watering

twice per week, on non- consecuti e c ays during the rnanihs of July and August, each at one- halfthe vveel ly application rate.

Average weekly rainfall rates for tlle Districi are:

r ua.Yy— a, 39" April- 0. 86"

February-- 0. 46" May- 1. 00"

March- 0. 48" June- 0. 63"

uly- 0.$

August- 0. 47"

September- 0. 74"

October- 0. 68"

November— O. b"

December- 0. 37"

Item 360. Concrete Pavemenf

urnish a CSS- 1P with greater thaza 50% asphali residue or the tack coat on this projec.

When using the Hardy Chair-Lok to support reinforcing steel, chair spacing nay be increased to1. 67 sq. yd. per chair, laced in a diamond or square pattern. Do not exceed 6a" Iongitcidinalspacing.

Tha pravi ions of Article 36fl. 6. 2, " Defzczent Thickness Adjustment," will nat be a requirerneni

and the pavemenf will nat be cored.

Include the approved rnix design number on each delivery ficket

Item 0,. Baxricades, Signs, and Traffic Handling

Permanent signs may be installed when construction in an area is eornplete and they wYll notconflict with the traffic control plan for the remainder ofthe job.

General Nates

GG Moss and ML Phillips SRTS Improvements

CPN '[ 02411

Project Num.ber: STP 2022( Ob9) TP

County: TARRANT

Highway: VA

Sheet G

Coz trol: 0902- 90-084

Existing sign are ta remain as long as they do not interfere wzth constructzon and khey do notconflict with the traffic control plan.

Any sign not detailed in the plans but called fax in the layout wi11 be as shown u the current

Sfiaza.dard Highway Sign Designs for Texas".

When traffic is obstructed, arrange war g devices in accordance with the latest edition of theTexas Manual an Uniform Traf' ic Control Devices".

Cover or xemove any work zone signs when work or candition re' erenced is ot occurring.

Da not place ba.rxicades, signs, nx any ather tra.ffic contral devices wher they interfere with sighfidistance at drivew ys r side s reets. Provide aecess to a1I driveways dia ring a11 phases ofconstruction r nless otherwise noted in the plans or as directed.

tem 06. Teznpora ry Erosion, Sedimentation, and Environmental Controls

The W3P for this project will consist ofusing tlie following items as d'zrected: Temparary sediment control fence

o Erosion coni ol logs

Remov accuznulated sedirnent or replace SW3P controls vvher the capacity has been reduced by50% or when the depth af sediment at the control struciure exceeds ane foot.

I ems 530 And 31. In ersections, Dri veways and Turnauts, and SidewaIks

The fiirnishing and installatian of the sand cushion in proposed sidewalks, sidewalk xamps, anddri.vetivays will not be paid far directly but 11 be subsidiary to this bid ite n.

Item 666. Refiectorized Pavemenf Markings with Retroreflective Requirements

Collection of retroreflectivity readin s using a mobile retroreflectometer is the preferred methad. If retrareflectivity readings are collected using a pariable or handheld unit, then measurement isdefined as a collective average af at least 20 reading taken along a 200- oot test section. Aminimum of three rrieasurements will be required per mile af roadway. Measurennents callectedon a centerline stripe will be a veraged s parately for stripe in each direction ofiravel.

General Notes

CC Moss and ML Phillips SRTS Improvements

CPN 102411