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Contract - Lone Star Sitework, LLC - 3/14/2024 CITY OF ROUND ROCK� 02--4 - 059 TRANSPORTATION DEPARTMENT ORIGINAL '0 ROUND ROCK TEXAS Project Manual For: CHISHOLM TR. RD. & W. OLD SETTLERS BLVD. INTERSECTION IMPROVEMENTS LIMITS: CHISHOLM TR. RD AT W. OLD SETTLERS BLVD. January 2024 Prepared By: American Structurepoint, Inc. ��P�E•OF TF�9s1,, Jw j STEVEN D.WI j 1-0...............................i l90��ttt``` 66138 � i W J�G / az4; 01/24/2024 APPROVED BY Steven D. Widacki, P.E. Date CIT' ATTORNEY: TBPE Firm Registration No F-10069 , t BID BOND THE STATE OF TEXAS § § KNOW ALL BY THESE PRESENTS: COUNTY OF WILLIAMSON § That Lone Star Sitework, LLC of the City of Wimberley County of Hays State of Texas as Principal, and Merchants Bonding Company(Mutual) authorized under the laws of the State of Texas to act as surety on bonds for principals,are held and firmly bound unto the CITY OF ROUND ROCK,TEXAS("Owner"), in the penal sum of Five Percent(5%)of the total amount of the Bid of the Principal submitted to the Owner, for the Work described below; for the payment whereof,well and truly to be made,and the said Principal and Surety do herby bind themselves and their heirs, administrators, executors, successors and assigns, jointly and severally,as follows: In no case shall the liability of the Surety hereunder exceed the sum of Five Percent of the Greatest Amount Bid Dollars($ 5% G.A.B. ). THE CONDITIONS OF THIS OBLIGATION ARE SUCH that,whereas,the Principal has submitted the above-referenced Bid to the Owner, for construction of the Work under the "Specifications for Construction of Chisholm Tr.Rd.&W.Old Settlers Blvd.Right Turn Lane Improvements for which Bids are to be opened at the office of Owner on the 13th day of February ,2024 . NOW,THEREFORE,if the Principal is awarded the Contract,and within the time and manner required under the"Instructions to Bidders,"after the prescribed forms are presented to her/him for signature,enters into a written Agreement substantially in the form contained in the Bid Documents,in accordance with the Bid, and files the two (2)bonds with the Owner, one to guarantee faithful performance and the other to guarantee payment for labor and materials,then this obligation shall be null and void;otherwise,it shall be and remain in full force and effect. If,however, Principal fails to enter into a written Agreement with the Owner in accordance with the Bid or Principal and Surety fail to timely deliver to Owner the performance and payment bonds required by the Bid Documents, Surety within five(5)business days after receipt of a written demand from Owner shall pay to Owner the full penal sum of this Bid Bond,subject to the limitation described herein. In the event that suit is brought upon this Bond by the Owner and judgment is recovered, said Surety shall pay all costs incurred by the Owner in such suit, including a reasonable attorney's fee to be fixed by the Court. IN WITNESS WHEREOF, the said Principal and Surety have signed this instrument on this the 13th day of the month of February 2024 . Lone Star Sitework, LLC _Merchants Bonding Company(Mutual) Principal Surety L`iAtden A6,((\S0rN Neira Hernandez Printed Name Printed Name By: Title: (,kX-\p,ckIr,c� X)(:)6gjy\Vlfr Title: Attorney-in-Fact Address: 405 Va- et�y Fudge Road Address: P.O. Box 14498 Wimberley, TX 78676 Des Moines, IA 50306-3498 00200 42020 Page 1 Bid Bond 00443638 Re nt A ent of Surety: S nature ("",-, Brady K. Cox Printed Name 500 N. Central Expressway, Suite 550 Street Address Plano, TX 75074 City, State,Zip Page 2 00200 4-2020 Bid Bond 00443638 ME RC HANTS"t*4, BONDING COMPANY.- POWER OF ATTORNEY Know All Persons By These Presents,that MERCHANTS BONDING COMPANY(MUTUAL)and MERCHANTS NATIONAL BONDING, INC., both being corporations of the State of Iowa,d/b/a Merchants National Indemnity Company(in California only)(herein collectively called the "Companies")do hereby make,constitute and appoint,individually, Blaine Allen;Brady K Cox;Brent Baldwin;Brock Baldwin;Chandler Nazzal;Cynthia A Alford;John A Aboumrad;Keith Rogers;Kristen Ortiz;Lorena Gutierrez;Michael B Hill;Neira Hernandez;Russ Frenzel;Samuel Freireich;Sylvia Thomas;Veronica Ramos;William D Baldwin;Yamillec Ramos their true and lawful Attorney(s)-in-Fact, to sign its name as surety(ies) and to execute, seal and acknowledge any and all bonds, undertakings, contracts and other written instruments in the nature thereof, on behalf of the Companies in their business of guaranteeing the fidelity of persons, guaranteeing the performance of contracts and executing or guaranteeing bonds and undertakings required or permitted in any actions or proceedings allowed by law. This Power-of-Attorney is granted and is signed and sealed by facsimile under and by authority of the following By-Laws adopted by the Board of Directors of Merchants Bonding Company (Mutual) on April 23, 2011 and amended August 14, 2015 and adopted by the Board of Directors of Merchants National Bonding,Inc.,on October 16,2015. "The President, Secretary, Treasurer, or any Assistant Treasurer or any Assistant Secretary or any Vice President shall have power and authority to appoint Attorneys-in-Fact, and to authorize them to execute on behalf of the Company, and attach the seal of the Company thereto, bonds and undertakings,recognizances,contracts of indemnity and other writings obligatory in the nature thereof." "The signature of any authorized officer and the seal of the Company may be affixed by facsimile or electronic transmission to any Power of Attorney or Certification thereof authorizing the execution and delivery of any bond, undertaking, recognizance, or other suretyship obligations of the Company,and such signature and seal when so used shall have the same force and effect as though manually fixed." In connection with obligations in favor of the Florida Department of Transportation only,it is agreed that the power and aut hority hereby given to the Attorney-in-Fact includes any and all consents for the release of retained percentages and/or final estimates on engineering and construction contracts required by the State of Florida Department of Transportation. It is fully understood that consenting to the State of Florida Department of Transportation making payment of the final estimate to the Contractor and/or its assignee, shall not relieve this surety company of any of its obligations under its bond. In connection with obligations in favor of the Kentucky Department of Highways only,it is agreed that the power and authority hereby given to the Attorney-in-Fact cannot be modified or revoked unless prior written personal notice of such intent has been given to the Commissioner- Department of Highways of the Commonwealth of Kentucky at least thirty(30)days prior to the modification or revocation. In Witness Whereof,the Companies have caused this instrument to be signed and sealed this 23rd day of January 2023 •`•.•(�ONq.''• •••.a1 C ••• MERCHANTS BONDING COMPANY(MUTUAL) .•• P . •• �•. O�. • OM�p.• MERCHANTS NATIONAL BONDING,INC. �''EtPOR' �� ;•O�''(>,POA' .9 . d/b/a MERCHANTS NATIONAL INDEMNITY COMPANY v: 2003 :`p 1933 c; By .s�. :Ovo �:d.� •. :'too` •••b�yi'' ��•• President STATE OF IOWA •., 1!1 ..• •.• COUNTY OF DALLAS ss. On this 23rd day of January 2023 before me appeared Larry Taylor, to me personally known, who being by me duly sworn did say that he is President of MERCHANTS BONDING COMPANY (MUTUAL)and MERCHANTS NATIONAL BONDING, INC.; and that the seals affixed to the foregoing instrument are the Corporate Seals of the Companies;and that the said instrument was signed and sealed in behalf of the Companies by authority of their respective Boards of Directors. i.a MM Lee — Q Commiss+on Nx spares z My Go-sparess A0114,2024 Notary Public (Expiration of notary's commission does not invalidate this instrument) I,William Warner,Jr.,Secretary of MERCHANTS BONDING COMPANY(MUTUAL)and MERCHANTS NATIONAL BONDING,INC.,do hereby certify that the above and foregoing is a true and correct copy of the POWER-OF-ATTORNEY executed by said Companies,which is still in full force and effect and has not been amended or revoked. In Witness Whereof, I have hereunto set my hand and affixed the seal of the Companies on this 13th day of February 2024 -0- a'. V •�.<• ��• _ 2003 :�� a 1933 c' Secretary POA 0018 (10/22) """ MERCHANTS BONDING COMPANY,, MERCHANTS BONDING COMPANY(MUTUAL) • MERCHANTS NATIONAL BONDING. INC. 2100 FLEUR DRIVE - DES MOINES, IOWA 50321-1158 • (800)678-8171 , (515)243-3854 FAX IMPORTANT NOTICE To obtain information or make a complaint: You may contact your insurance agent at the telephone number provided by your insurance agent. You may call Merchants Bonding Company (Mutual) toll-free telephone number for information or to make a complaint at: 1-800-678-8171 You may contact the Texas Department of Insurance to obtain information on companies, coverages, rights or complaints at: 1-800-252-3439 You may write the Texas Department of Insurance at: P. O. Box 149104 Austin, TX 78714-9104 Fax: (512)475-1771 Web: http://www.tdi.state.tx.us E-mail: ConsumerProtection@tdi.texas.gov PREMIUM AND CLAIM DISPUTES: Should you have a dispute concerning your premium or about a claim you should contact the agent first. If the dispute is not resolved, you may contact the Texas Department of Insurance. ATTACH THIS NOTICE TO YOUR POLICY: This notice is for information only and does not become a part or condition of the attached document. SUP 0032 TX(12/13) BID FORM PROJECT NAME: Chisholm Tr. Rd. & W. Old Settlers Blvd. Intersection Improvements PROJECT LOCATION: Round Rock,Texas OWNER: City of Round Rock,Texas DATE: March 2022 Gentlemen: Pursuant to the foregoing Notice to Bidders and Instructions to Bidders,the undersigned bidder hereby proposes to do all the Work,to furnish all necessary superintendence, labor,machinery, equipment,tools, materials, insurance and miscellaneous items,to complete all the Work on which he bids as provided by the attached Bid Documents, and as shown on the plans for the construction of Chisholm Tr. Rd. & W. Old Settlers Blvd. Intersection Improvements and binds himself on acceptance of this bid to execute the Agreement and bond for completing said Work within the time stated, for the following prices,to wit: Any addenda issued will be posted with the Project Manual and/or Contract Documents on the City's website at by the close of business on Prior to submitting a bid,the bidder is responsible for determing if any addenda have been issued and for following any instructions in any addenda issued. Bidder acknowledges receipt of the following Addenda by listing Addendum "number" and "date". rn --a- C9- 1,3 f U BASE BID Bid Item Approx. Unit Item Description and Written Unit Price Unit Price Amount Quantity 1 6.3 STA 100 6002 PREPARING ROW complete in place per STATION for Three thousand five hundred dollars and zero cents $ 3,500.00 $22,050.00 2 288 SY 104 6015 REMOVING CONC (SIDEWALKS) $ - complete in place per SQUARE YARD $ for Thirteen dollars $ - and fifty cents $ 13.50 $ 3,888.00 Bid Form 00200-9-2015 Page 1 of 13 Addendum#2 BASE BID Bid Item Approx. Unit Item Description and Written Unit Price Unit Price Amount Quantity 3 71 SY 104 6017 REMOVING CONC(DRIVEWAYS) $ - complete in place per SQUARE YARD $ for Thirteen dollars $ and fifty cents $ 13.50 $ 958.50 104 6022 REMOVING CONC 4 785 LF (CURB AND GUTTER) $ - complete in place per LINEAR FOOT $ for nine dollars $ - and forty cents $ 9.40 $ 7,379.00 5 657 CY 110 6001 EXCAVATION(ROADWAY) $ - complete in place per CUBIC YARD $ for fourty dollars $ - and zero cents $ 40.00 $26,280.00 132 6001 EMBANKMENT 6 133 CY (FINAL)(ORD COMP)(TY A) $ - complete in place per CUBIC YARD $ for one hundred fifity dollars $ and zero cents $ 150.00 $19,950.00 160 6003 FURNISHING AND 7 511 SY PLACING TOPSOIL(4") $ - complete in place per SQUARE YARD $ for thirty one dollars $ and zero cents $ 31.00 $15,841.00 8 511 SY 162 6002 BLOCK SODING $ - complete in place per SQUARE YARD $ for twelve dollars $ - and zero cents $ 12.00 $ 6,132.00 9 15 MG 168 6001 VEGETATIVE WATERING $ - complete in place per MILLION GALLONS $ for three hundred dollars $ - Bid Form 00200-9-2015 Page 2 of 13 Addendum#2 BASE BID Bid Item Approx. Unit Item Description and Written Unit Price Unit Price Amount Quantity and zero cents $ 300.00 $ 4,500.00 10 439 TON 340 6004 D-GR HMA(SQ) TY-A PG64-22 $ - complete in place per TONS $ - for one hundred ninety dollars $ and zero cents $ 190.00 $83,410.00 11 142 TON 340 6011 D-GR HMA(SQ)TY-B PG64-22 $ - complete in place per TONS $ for two hundred twenty five dollars $ and zero cents $ 225.00 $31,950.00 12 79 TON 340 6048 D-GR HMA(SQ) TY-C SAC-B PG70-22 $ - complete in place per TONS $ for two hundred thirty dollars $ and zero cents $ 230.00 $18,170.00 13 27 LF 402 6001 TRENCH EXCAVATION PROTECTION $ - complete in place per LINEAR FOOT $ for fourty dollars $ - and zero cents $ 40.00 $ 1,080.00 14 8 LF 416 6029 DRILL SHAFT (RDWY ILL POLE)(30 IN) $ - complete in place per LINEAR FOOT $ for nine hundred sixty eight dollars $ - and zero cents $ 968.00 $ 7,744.00 15 12 LF 416 6030 DRILL SHAFT (TRF SIG POLE)(24 IN) $ - complete in place per LINEAR FOOT $ for seven hundred fifty dollars $ - and zero cents $ 750.00 $ 9,000.00 16 100 LF 450 6047 RAIL (HANDRAIL)(TY A) $ - complete in place per LINEAR FOOT $ - Bid Form 00200-9-2015 Page 3 of 13 Addendum #2 BASE BID Bid Item Approx. Unit Item Description and Written Unit Price Unit Price Amount Quantity for one hundred twenty dollars $and zero cents $ 120.00 $12,000.00 17 14 LF 462 6299 CONC BOX CULV (3FTXIFT)(CIP) $ - complete in place per LINEAR FOOT $ for one thousand eighty dollars $ and zero cents $ 1,080.00 $15,120.00 18 8 LF 464 6001 RC PIPE(CL III)(12 IN) $ - complete in place per LINEAR FOOT $ for one hundred forty dollars $ - and zero cents $ 140.00 $ 1,120.00 19 46 LF 464 6005 RC PIPE(CL III)(24 IN) $ - complete in place per LINEAR FOOT $ for two hundred dollars $ - and zero cents $ 200.00 $ 9,200.00 20 70 LF 464 6032 RC PIPE(ARCH)(CL III)(DES 3) $ - complete in place per LINEAR FOOT $ for three hundred fifty dollars $ - and zero cents $ 350.00 $24,500.00 21 1 EA 465 6006 JCTBOX(COMPL)(PJB)(4FTX4FT) $ - complete in place per EACH $ for seven thousand eight hundred dollars $ - and zero cents $ 7,800.00 $ 7,800.00 22 1 EA 465 6010 JCTBOX(COMPL)(PJB)(5FTX6FT) $ - complete in place per EACH $ for nine thouseand two hundred dollars $ - and zero cents $ 9.200.00 $ 9,200.00 23 1 EA 465 6015 INLET(COMPL)(PCO)(3FT)(RIGHT) $ - Bid Form 00200-9-2015 Page 4 of 13 Addendum#2 BASE BID Bid Item Approx. Unit Item Description and Written Unit Price Unit Price Amount Quantity complete in place per EACH $ for six thousand nine hundred fifty dollars $and zero cents $ 6,950.00 $ 6,950.00 24 1 EA 465 6016 INLET(COMPL)(PCO)(3FT)(BOTH) $ - complete in place per EACH $for six thousand nine hundred fifty dollars $and zero cents $ 6,950.00 $ 6,950.00 25 40 LF 474 6005 SLOT DRAIN (GAL STL)(18 IN) $ - complete in place per LINEAR FOOT $for one hundred eighty dollars $and zero cents $ 180.00 $ 7,200.00 474 6006 SLOT DRAIN OUTFALL 26 6 LF (GAL STL)(18 IN) $ complete in place per LINEAR FOOT $for eight hundred dollars $and zero cents $ 800.00 $ 4,800.00 479 6005 ADJUSTING MANHOLES 27 3 EA (WATER VALVE BOX) $ - complete in place per EACH $for five hundred dollars $and zero cents $ 500.00 $ 1,500.00 28 1 EA 479 6006 ADJUSTING INLET(CAP) $ - complete in place per EACH $for two thousand four hundred dollars $and zero cents $ 2,400.00 $ 2,400.00 29 3 EA 496 6002 REMOV STR(INLET) $ - complete in place per EACH $for eight hundred dollars $and zero cents $ 800.00 $ 2,400.00 Bid Form 00200-9-2015 Page 5 of 13 Addendum#2 BASE BID Bid Item Approx. Unit Item Description and Written Unit Price Unit Price Amount Quantity 30 308 LF 496 6040 REMOV STR(RET WALL) $ - complete in place per LINEAR FOOT $ - for twenty dollars $ - and zero cents $ 20.00 $ 6,160.00 502 6001 BARRICADES, SIGNS AND 31 4 MO TRAFFIC HANDLING $ - complete in place per MONTH $ for one thousand nine hundred dollars $ - and zero cents $ 1,900.00 $ 7,600.00 32 482 LF 506 6038 TEMP SEDMT CONT FENCE (INSTALL) $ - complete in place per LINEAR FOOT $ - for five dollars $ - and zero cents $ 5.00 $ 2,410.00 33 482 LF 506 6039 TEMP SEDMT CONT FENCE(REMOVE) $ - complete in place per LINEAR FOOT $ for one dollars $ - and twenty cents $ 1.20 $ 578.40 34 96 LF 506 6040 BIODEG EROSN CONT LOGS (INSTL) (8") $ - complete in place per LINEAR FOOT $ for ten dollars $ - and sixty cents $ 10.60 $ 1,017.60 35 96 LF 506 6043 BIODEG EROSN CONT LOGS (REMOVE) $ - complete in place per LINEAR FOOT $ for six dollars $ - and zero cents $ 6.00 $ 576.00 36 755 LF 529 6008 CONC CURB & GUTTER(TY H) $ - complete in place per LINEAR FOOT $ for thirty seven dollars $ - Bid Form 00200-9-2015 Page 6 of 13 Addendum#2 BASE BID Bid Item Approx. Unit Item Description and Written Unit Price Unit Price Amount Quantity and zero cents $ 37.00 $27,935.00 37 141 LF 529 6015 CONC CURB (TY Cl) $ - complete in place per LINEAR FOOT $ for one hundred seventy dollars $ and zero cents $ 170.00 $23,970.00 38 94 SY 530 6004 DRIVEWAYS (CONC) $ - complete in place per SQUARE YARD $ for one hundred twenty six dollars $ and zero cents $ 126.00 $11.844.00 39 263 SY 531 6001 CONC SIDEWALKS (4") $ - complete in place per SQUARE YARD $ for one hundred nine dollars $ and zero cents $ 109.00 $28,667.00 40 84 SY 5316003 CONC SIDEWALKS (6") $ - complete in place per SQUARE YARD $ for one hundred forty seven dollars $ and zero cents $ 147.00 $12,348.00 41 3 EA 531 6004 CURB RAMPS (TY 1) $ - complete in place per EACH $ for two thousand three hundred fifty dollars $ - and zero cents $ 2,350.00 $ 7,050.00 42 1 EA 5316010 CURB RAMPS (TY 7) $ - complete in place per EACH $ two thousand seven hundred for seventy five dollars $ - and zero cents $ 2,775.00 $ 2,775.00 43 1 EA 610 6004 RELOCATE RD IL ASM(TRANS-BASE) $ - Bid Form 00200-9-2015 Page 7 of 13 Addendum#2 BASE BID Bid Item Approx. Unit Item Description and Written Unit Price Unit Price Amount Quantity complete in place per EACH $for five tousand six hundred forty dollars $ - and zero cents $ 5,640.00 $ 5,640.00 44 600 LF 618 6033 CONDT (PVC) (SCH 40) (4") $ - complete in place per LINEAR FOOT $ for forty six dollars $ and zero cents $ 46.00 $27,600.00 45 22 LF 618 6046 CONDT (PVC) (SCH 80) (2") $ - complete in place per LINEAR FOOT $ for one hundred eighty dollars $ - and zero cents $ 180.00 $ 3,960.00 46 22 LF 620 6007 ELEC CONDR(NO.8) BARE $ - complete in place per LINEAR FOOT $ for six dollars $ - and zero cents $ 6.00 $ 132.00 47 1 EA 624 6002 GROUND BOX TY A (122311)W/APRON $ - complete in place per EACH $ for three thousand one hundred eighty dollars $ - and zero cents $ 3,180.00 $ 3,180.00 48 3 EA 624 6009 GROUND BOX TY D (162922) $ - complete in place per EACH $ for two thousand eight hundred eighty dollars $ - and zero cents $ 2,880.00 $ 8,640.00 49 3 EA 624 6010 GROUND BOX TY D (162922)W/APRON $ - complete in place per EACH $ for three thousand seven hundred dollars $ and zero cents $ 3,780.00 $11,340.00 Bid Form 00200-9-2015 Page 8 of 13 Addendum#2 BASE BID Bid Item Approx. Unit Item Description and Written Unit Price Unit Price Amount Quantity 50 2 EA 644 6001 IN SM RD SN SUP&AM TYIOBWG(I)SA(P) $ - complete in place per EACH $ for one thousand sixty dollars $ - and zero cents $ 1,060.00 $ 2,120.00 644 6068 RELOCATE SM RD SN SUP&AM 51 2 EA TY 1OBWG $ - complete in place per EACH $ for six hundred dollars $ - and zero cents $ 600.00 $ 1,200.00 52 315 LF 666 6027 REFL PAV MRK TY I(W)8"(BRK)(100MIL) $ - complete in place per LINEAR FOOT $for two dollars $ - and seventy cents $ 2.70 $ 850.50 53 471 LF 666 6036 REFL PAV MRK TY I(W)8"(SLD)(100MIL) $ - complete in place per LINEAR FOOT $ for two dollars $ - and forty cents $ 2.40 $ 1,130.40 666 6042 REFL PAV MRK TY I 54 666 LF (W)12"(SLD)(100MIL) $ - complete in place per LINEAR FOOT $ for six dollars $ - and zero cents $ 6.00 $ 3,996.00 666 6048 REFL PAV MRK TY I 55 150 LF (W)24"(SLD)(100MIL) $ - complete in place per LINEAR FOOT $ for twelve dollars $ - and zero cents $ 12.00 $ 1,800.00 666 6054 REFL PAV MRK TY I 56 3 EA (W)(ARROW)(IOOMIL) $ - complete in place per EACH $ for two hundred forty dollars $ - Bid Form 00200-9-2015 Page 9 of 13 Addendum#2 BASE BID Bid Item Approx. Unit Item Description and Written Unit Price Unit Price Amount Quantity and zero cents $ 240.00 $ 720.00 57 3 EA 666 6078 REEL PAV MRK TY I(W)(WORD)(100MIL) $ - complete in place per EACH $for two hundred forty dollars $ - and zero cents $ 240.00 $ 720.00 58 315 LF 666 6175 REFL PAV MRK TY II(W) 8" (BRK) $ - complete in place per LINEAR FOOT $ for one dollars $ - and eighty cents $ 1.80 $ 567.00 59 471 LF 666 6178 REFL PAV MRK TY II(W) 8" (SLD) $ - complete in place per LINEAR FOOT $ for one dollars $ - and sixty cents $ 1.60 $ 753.60 60 666 LF 666 6180 REFL PAV MRK TY II(W) 12" (SLD) $ - complete in place per LINEAR FOOT $for two dollars $ - and forty cents $ 2.40 $ 1,598.40 61 150 LF 666 6182 REFL PAV MRK TY II(W) 24" (SLD) $ - complete in place per LINEAR FOOT $for four dollars $and eighty cents $ 4.80 $ 720.00 62 3 EA 666 6184 REFL PAV MRK TY H(W) (ARROW) $ - complete in place per EACH $ for one hundred twenty dollars $ - and zero cents $ 120.00 $ 360.00 63 3 EA 666 6192 REFL PAV MRK TY II (W) (WORD) $ - complete in place per EACH $ - Bid Form 00200-9-2015 Page 10 of 13 Addendum#2 BASE BID Bid Item Approx. Unit Item Description and Written Unit Price Unit Price Amount Quantity for one hundred twenty dollars $and zero cents $ 120.00 $ 360.00 64 18 EA 672 6007 REFL PAV MRKR TY I-C $ - complete in place per EACH $for nine dollars $ - and sixty cents $ 9.60 $ 172.80 65 218 LF 677 6001 ELIM EXT PAV MRK&MRKS (4") $ - complete in place per LINEAR FOOT $ for one dollars $ - and twenty cents $ 1.20 $ 261.60 66 530 LF 677 6005 ELIM EXT PAV MRK& MRKS (1211) $ - complete in place per LINEAR FOOT $ for three dollars $ - and twenty five cents $ 3.25 $ 1,722.50 67 437 LF 677 6007 ELIM EXT PAV MRK&MRKS (24") $ - complete in place per LINEAR FOOT $for six dollars $ - and fifty cents $ 6.50 $ 2,840.50 68 8 EA 682 6018 PED SIG SEC (LED)(COUNTDOWN) $ - complete in place per EACH $for one thousand four hundred dollars $ and zero cents $ 1,400.00 $11,200.00 69 32 LF 684 6029 TRF SIG CBL(TY A)(14 AWG)(3 CONDR) $ - complete in place per LINEAR FOOT $ for six dollars $ - and sixty cents $ 6.60 $ 211.20 70 82 LF 684 6031 TRF SIG CBL(TY A)(14 AWG)(5 CONDR) $ - Bid Form 00200-9-2015 Page 11 of 13 Addendum#2 BASE BID Bid Item Approx. Unit Item Description and Written Unit Price Unit Price Amount Quantity complete in place per LINEAR FOOT $for six dollars $and ninety five cents $ 6.95 $ 569.90 71 4 EA 687 6001 PED POLE ASSEMBLY $ - complete in place per EACH $one thouseand nine hundred ninety for two dollars $and zero cents $ 1,992.00 $ 7,968.00 72 4 EA 687 6005 REMOVE PED POLE ASSEMBLY $ - complete in place per EACH $for four hundred sixty eight dollars $and zero cents $ 468.00 $ 1,872.00 73 8 EA 688 6001 PED DETECT PUSH BUTTON (APS) $ - complete in place per EACH $ for two thousand one hundred sixty dollars $and zero cents $ 2,160.00 $17,280.00 74 3 EA 690 6057 REMOVAL OF PEDESTRIAN RAMPS $ - complete in place per EACH $for five hundred dollars $and zero cents $ 500.00 $ 1,500.00 75 4 EA 1004 6001 TREE PROTECTION $ - complete in place per EACH $ for four hundred fifty dollars $ - and zero cents $ 450.00 $ 1,800.00 5072 6002 FRNISH& INSTAL PRECST 76 8 EA CONC WHEEL STOPS $ - complete in place per EACH $ for one hundred forty dollars $ - and zero cents $ 140.00 $ 1,120.00 Bid Form 00200-9-2015 Page 12 of 13 Addendum#2 BASE BID Bid Item Approx. Unit Item Description and Written Unit Price Unit Price Amount Quantity Bid Form 00200-9-2015 Page 13 of 13 Addendum #2 BASE BID Bid Item Approx. Unit Item Description and Written Unit Price Unit Price Amount Quantity TOTAL BASE BID (Items 1 thru'76) $628,309.90 Materials: $295,000.00 All Other Charges: $333,309.90 *Total: $628,309.90 * Note: This total must be the same amount as shown above for "Total Base Bid" If this bid is accepted,the undersigned agrees to execute the Agreement and provide necessary bonds and insurance certification as per the Instructions to Bidders. The undersigned certifies that the bid prices contained in the bid have been carefully checked and are submitted as correct and final. The Owner reserves the right to reject any or all bids and may waive any informalities or technicalities. Respectfully Submitted_ ignature Cullen Harrison PO BOX 1867, Wimberley, TX 78676 Print Name Address Managing Member 512-393-1582 Title Telephone LONE STAR SITEWORK, Name of Firm 2/13/2024 Date Secretary, if Bidder is a Corporation Bid Form 00200-9-2015 Page 14 of 13 Addendum #2 BASE BID Bid Item Approx. Unit Item Description and Written Unit Price Unit Price Amount Quantity Bid Form 00200-9-2015 Page 15 of 13 Addendum#2 00410 STATEMENT OF BIDDER'S SAFETY EXPERIENCE Page 1 00410 8-2014 Statement of Bidder's Safety Experience 00090654 Solicitation Requirements, Contract Forms & Conditions of Contract Statement of Bidder's Safety Experience Section 00410 Bidder must submit a signed Statement of Bidder's Safety Experience form with his Bid; failure to do so will constitute an incomplete Bid that may be rejected. In order to make a responsive Bid, Bidder must provide evidence that it meets minimum OSHA construction safety program requirements, has not been fined by OSHA for any willful safety violations in the past three years, and has a lost time injury rate that doesn't exceed the limits established below. All questions must be answered and data given must be clear and comprehensive. If necessary, questions may be answered on separate attached sheets. Company Name: Lone Star Sitework, LLC Address: PO BOX 1867, Wimberley, TX 78676 Phone: 512-393-1582 Completed by: Cullen Harrison Date: 02/12/2024 1. Does the company have a written construction Safety program? ✓❑Yes ❑No 2. Does the company conduct construction safety inspections? ✓❑Yes ❑No 3. Does the company have an active construction safety-training program? ❑Yes FZ]No 4. Has the company been fined by OSHA for any willful safety violations in the past ❑Yes ✓❑No three years? 5. Does the company have a lost time injury rate of 7.8 for SIC 15, or 7.6 for SIC 16, []Yes El No or less over the past three years? Attach the company's OSHA 200/300 logs for the past three years. 6. Does the company or affected subcontractors have competent persons in the following Areas? A. Scaffolding ❑Yes [:]No ✓❑N/A B. Excavation ❑✓ Yes ❑No ❑N/A C. Cranes ❑Yes []No ❑✓ N/A D. Electrical ❑Yes ❑No ❑✓ N/A E. Fall Protection ❑Yes ❑No 0 N/A F. Confined Spaces ❑Yes []No 0 N/A I hereby certify that the above information is true and correct. Signature�.�yr, Title Managing Member Page 1 00410 8-2014 Statement of Bidder's Safety Experience 00090654 Note:You can type input into this form and save it. Year 20 23 OSHA's Form 300A (Rev 04/2004) Because the forms in this recordkeeping package ares andlelwritable" U.S.Department of Labor PDF documents,you can type into the input form fields and then save your inputs using the free Adobe PDF Reader. 0...p,h...I s.r ty.nd H-1th A&W.W."d— Summary of Work-Related Injuries and Illnesses Fotmapp_cdoMaro 121"196 All establishments covered by Part 1904 must complete this Summary page,even if no work-related injuries or illnesses occurred during the year. Remember to review the Log to verify that the entries are complete and accurate before completing this Using the Log,count the individual entries you made for each category. below,making sure you've added the entries from Establishment information every page of the Log.If you had no cases,write V." LONE STAR SITEWORK, LLC p g provisions for Yoeres ablishmentnama Employees,former employees,and their representatives have the right to review the OSHA Form 300 in its entirety.They also have limited access to the OSHA Form 301 or its equivalent. See 29 CFR Part 1904.35,in OSHA's recordkee in rule,for further details on the access p PO BOX 1867 these forms. Street City WIMBERLEY state TX Zip 78676 Number of Cascs Total number of industry description(e.g.,Manufacture of motor truck trailers) Total number of Total number of Total number of cases deaths cases with days with job transfer or other recordable HIGHWAY,STREET&BRIDGE CONSTRUCTION away from work restriction cases 0 North American Industrial Classification(NAICS),if known(e.g.,336212) O 0 (�) (H) p) P 2 3 7 3 1 0 Employment information(Ifyou don't have these figures,.see the Numberof Days Worksheet on the next page to estimate) Total number of days Total number of days of 29 job transfer or restriction Annual average number of employees away from work 72,640.00 0 0 Total hours worked by all employees last year (K) (t_) Sign here Knowingly falsifying this document may result in a fine. injury and Illness Types I certify that I have examined this document and that to the best of Total number of... my knowledge the entries true,accurate,and complete. Tot (al Mi UK 0 Mr.nr Ai n cr�Q (1)Injuries 0 (4) Poisonings `/— T ' Title Company executive (2) Skin disorders 0 (5) Hearing loss 0 Phone 512-393-1582 Date 01/15/2024 (3)Respiratory conditions 0 (6) All other illnesses 0 Reset Post this Summary Page from February 1 to April 30 of the year following the year covered by time to r �theiv afor tions,sea ch and gather the data needed,and Public reporting burden for this collection of information is estimated W average 5g minutes per response, g complete and review the c0lkroti0n of information.Persons are rat required to respond to the collection of information unless it displays a Amatysis Rood OMB 40,201 number.tf you have any completes about these estimates of any other aspects of this data collection,contact US Department of labor,OSHA Office of Statistical Annlysis,Room N-3644,200 Constitution Avenue,NW, Washington,DC 20210.Do not send the completed forms to this office OSHA's Form 300 (Rev 04/2004) N ote: type input into this form and savFds Attention:Thisform contains information relating to orms In this recordkeeping package al'ble/writable" employee health and must be used in a manner that Year 20 23 le the Log of Work-Related ts,you can type into the input form find protects the confidentiality of employees to the extent _ used U.S.Department of Labor ss r inputs using the free Adobe PDF Reaoderate.In addition, o�cupationaible ll safety and hle the ealth purpoon is ses for occupetionel Safety•nd Naa/ih AdieiNerred•e Injuries and Illnesses programmed to auto-calculate as app p Form approved OMB m.1218-0176 Reminders: LONE STAR SITEWORK, LLC Please Record: Complete an Injury and Illness Incident Report(OSHA Form 301)or equivalent •Information about every work-related death and about every work-related injury or illness that involves loss first form for each injury or illness recorded on this form.Ifyou're not sure whether a EstaMisnment name consciousness,restricted work activityorjobtransfer,daysawayfromworkormedicaltreatmen[beyondRntaid. case is recordable,callyourlocal OSHA a(>iceforhelp. c8Y WIMBERLEY TX 9 y physician or licensed health care professional. stare •Significant work-related injuries and illnesses that are diagnosed b a phy Feel hes to use two lines for a single case if you nee to. .Work-related injuries and illnesses that meet any of the specific recording criteria listed in 29 CFR Part 1904.8 .Complete the s steps for each case. through 1904.11. Step 3.Classify the CaseStep 1.Iderijify the petsor? 1 Step 2. .1 Describe Enter the number of select one column: (C) (D) (E) (F) days the injured or Ill (A) (8) injury arts of bo worker was: Job title Date of injury where the event occurred Describe in u or illness,p body Ilircss Case Employee's name e. Lcwdin dock north end) affected,and objectlsubstance that Remained at Work ao. (c.g..Welder) or onset of ( g• g directly injured or made person ill(e.g., r (M) o illness Second degree hunts on right forearm from On lob (e g )f�) Days away Job transfer other record A� transfer or t acetylene torch) Death from work or restriction eblo e s work restriction c - $ (G) (H) (I) (J) (K) (1) (2) (3) (4) (5) (6) 0 0 0 0 _dare _oars 0 00000 Reset p colder 000000 _lava —days Reset —I— nth mo /day0 0 0 0 _aari _day, 000000 Reset mon,h I day 0000000 _aay _days Reset month I day 0 0 0 0 _da000000 ys _days Reset monm/day 00 -Dari __days Reset nronthIday 00 0000 0 00 0 _ders _aays Reset moron I day 0 0 0 0 __days _days 000000 Reset month f day 000000 _-aays _days Reset f monthlday 0 0 0 0 _days _aura 000000 Reset —f— month".y 0 0 0 0 O O O O O Q Page iota/s , O O ——— Publ.reporting burden for this calleaion of inbrmation is esume ed to m<rage IS Immnes per response,occluding tine to mirn the __ _9 L f �_ 6 ielructwnc,search and gather the data rsxded.and complete and misty the collection of uffornrxlion Persons am not regwred to l Add a Form Page Besure to trens/er these totals to the Summery page(Form 300A)before You post it a4 Y _3 respond to the wllecuon m infamwuon unl_tt displa3 s a curmally laid OMB wutrol mrrnber.If you bore any comments about Ihese 9 rs a < estinntes or any other aspects of Itus dari eollenion cornett.US Depanrrem of Labor.OSHA(Mus of Swtrdical Arial)sis.Room 'd n J o = N-36J�t.2W Comtnutwn A—NW.Washington DC 10210.Do not wird the completed foam Io this office. (1) (2) (3) (4) (5) (Q OSHA's Form 301 (Rev.04/2004) Note:You can type input into this form and save it. Attention:This form contains information relating to Because the forms in this recordkeeping package are"finable/writable" employee health and must be used in a manner that Injury and 111 n e ss PDF documents,you can type into the Input form fields and protects the confidentiality of employees to the extent U.S.Department of Labor then save your inputs using the free Adobe PDF Reader.In addition, possible while the information is being used for oocup.dan.t sarety andtr..nh Ado0n,lf inti i Incident Report the forms are programmed to auto-calculate as appropriate occupational safety and health purposes. Form apprncod OMB an,1218-0176 Information about the employee Information about the case This Injury and Illness Incident Report is one of the to)Case number from the Log (Transfer the rose m+mberfram die Log afar Ism rnr rd the case.) first forms you must fill out when a recordable 1) Full name work-related injury or illness has occurred.Together i p Date of injury or illness with the Log of Work-Related Injuries and Illnesses 2)Street Month Day Year and the accompanying Summary,these forms help 12)7 one too ployee began work(HH Mtn ©AM PM the employer and OS1 A develop a picture of the City State ZIP /3)Time of event(FRthLM) ©AM QPM O Check i(lime cannot be Jeturraine extent and severity of work-related incidents. s)Daleerbirtn min�t-o'Re fields 14 to 17:Please do not include any personalty identifiable inforrrrdtion(Pit))arta Within 7 calendar days after you receive worker(s)involved in the incident(e.g.,no names,phone numbers,or Social Security numbers)- Month Ds' Yuu information that a recordable work-related injury or 14)•What was the employee doing Just before the Incident occurred?Describe the activity,as well as rhe - illness has occurred.you must fill out this form Oran Date hired tools,equipment,or material the employee was frog specific Examples:"dumbing a ladder while ing roofing materials","spraying chlorine from hanan d sprayer "daily computer key-entry." equivalent.Some state workers'compensation, Month Day Ycar carry insurance,or other reports may be acceptable 3)O Mate O Female substitutes.To be considered an equivalent form,any Information about the physician or other health care substitute must contain all the information asked for professional 13)•Whet Happened?Tell its how the injury occurred.£.xamplrs:"When ladder slipped on wr1 floor,worker felt On this form. 6) Name of physician or other health care professional 20 feet""Worker was sprayed with chlorine when gasket broke during replacement";-Worker developed According to Public Law 91-596 and 29 CFR soreness in wrist over time' 1904,OSIIA's recordkeeping rule,you must keep this form on file for 5 years following the year to which it pertains. '>)If treatment was given away from the worksite,where was it given? If you need additional copies of this form,you may photocopy the printout or insert additional form Facility E_16)•What was the injury or Illness?Tell us the part of the body that was affected and how rt was affected pages in the PDF,and then use as many as you need. 1�rumplev:"strained back,,;"chemical burn,hand'.;"carpal tunnel syndrome Street City state ZIP 17).What object orsu6stence directly harmed the employee?Examples:"concrete floor;"chlorine": 8)Was employee treated in an emergency room? "radia)arm saw."If ibis question does not upply to the incident,leave it black. L512-393-1582 �i'lL` 0 Yes Q No ber 9)Was employee hospilaliud overnight as an in-patient? 18) Mthe employee died,when did death occuA Date of death Month Dai' Year Date 01/15/2024 O Yes Month Day Year O No [ Add a Form Page Reset Public reportingburden(orflis coaecuon of iNorrmuon is estimated to as'erage?2 onrmtesperresporiu.+rcliakrrg time for+n iewtrtg unwcdom,searching evis+ing data sources,gati-ing and nnintaining th data reerinl,nrdconr.IAe 3and,Rw.gthe4,200C o(m,..A,.n.,NW,arerotrequired torespond to the colkcsiun of infarrteainn nolessn d,spla>sn Public.olid OMB coram)number.if you have arty comments about ilia ee.g.22 any cher aspens o!nus data collection including suggestiora for reducing this bunlea,contact us Depanincnt of Labor.OSHA Office of Sratisrinl AuelKis,Ronin N-3641,1W Corcainaion A.ewe.NW,W+uhington.�'2n210.lb not scud or conpkued loran to rets office Ar 14 Year 2022 0 OSHA's Form 300A (Rev.01/2004) U.S.Department of Labor Summary of Work-Related Injuries and IllnessesOoeuWv—u Safety and Health Administrallm Form approved OMB no.1219-0178 All establishments covered by Port 1904 must complete this Summary page,even it no injuries or illnesses occurred during the year. Remember to review the Log to verify that the entries are complete Establishment information Using the Log,count the individual entries you made for each category. Then write the totals below, making sure you've added the entries from every page of the log. ff you had no cases write'0.' your establishment name LONE STAR SITEWO LLC Employees former employees,and their representatives have the fight to review the OSHA Form 300 in its entirety. They also have limited access to the OSHA Form 301 or its equivalent. See 29 CFR Street PO BOX 1867 1904.35,in OSHA's Recordkeeping rule,for further details on the access prowsfons for these forms. Zip 78676 Cly WIMBERLEY State TX Wiijimbw of Industry descnpUon(e.g.,Manufacture of molar truck trailers) HIGHWAY STREET&BRIDGE CONSTRUCTION Total number of Total number of Total number of cases Total number of deaths cases with days with job transfer or other recordable Standard Industnal Classification(SIC),K known(e.g_SIC 3715) away from work restriction cases 0 0 0 0 (G) (H} (I) (.1) OR North Amencan Industrial classification(NAICS),if known(e.g.,338212) 2 3 7 3 1 0 Employment information 'Number of Days; .. .� Y Y .tet i Total number of Total number of days ofAnnual average number of employees 26 days awe from job transfer or restriction dark y Total hours worked by all employees last year 62,862 0 0 (kl (L) Injury and li ness Types Sign here Knowingly falsifying this document may result in a fine. Total number of... (M) (1) injury 0 (4) Poisoning 0 (2) Skin Disorder 0 (5) Hearing Loss 0 1 certify that I have examined this document and that to the best of my knowledge the entries are we,Accu ate,and (3) Respiratory complete. Condition 0 (6)All Other Illnesses 0 MANAGING MEMBF T —_ MV"Companyexecutive 1/122023 512-393-1582 Date phone Post this Summary page from February 1 to April 30 of the year following the year covered by the form Public reporting burden for this cn8ectm of information is estimated to average 58 minutes per response,including time to review the instruction,search and gather the data needed,and con-Oats and review the collection of information.Persons am not required to respond to the collection of Infommation unlesa a displays a cumarty valid OMB control numberifou have any comments about these estimates or any aspects of this data collectiocomfort:n, nfort:OS Department of Y Labor.OSHA Office of Statistics.Room N-364a.:Cq r—stitut-Ave.NW.Vt r,'mW DC 7071 G.thio int Bond theconwiered forme to friss oKxe. ,.. _ _ _ _ _ ..._ --. - - Attention: This form contains information relating to employee health and must be used in a manner Year 22 OSHA'S Form 300 (Rev.0112004) that protects the confidentiality employeestothe eMent possible while the informaation is being used U.S. Department of Labor for occupational safety and health purposes Log of Work-Related Injuries and Illnesses occupational Safety and Health Administration You must record information about every work-related injury or illness that involves loss of consciousness,restricted Work activity or job transfer,days away from work,or medical treatment Form approved OMB no.1218-0178 beyond first aid.You must also record significant work-related Injuries and illnesses that are diagnosed by a physician or licensed health care professional.You must alsorecord work-related Establishment name LONE STAR SITEWORK,LLC injuries and illnesses that meet any of the specific recording criteria listed in 29 CFR 1904.8 through 1904.12. Feel free to use five lines for a single case if you need to.You must complete an injury and illness incident report(OSHA Form 301)or equivalent form for each injury or illness recorded on this form, If you're not sure whether a case is recordable,call your local OSHA State TX office for help. City WIMBERLEY � .::.. . Identify the person Describe the case Classify the case Enter the number of (A) (B) (C) (D) (E) (F) CHECK ONLY ONE box for each case based on days the injured or ill Check the"injury"column or choose one type of Case Employee's Name Job Title (e.g., Date of Where the event occurred(e.g- Descaibe injury or illness,parts of body alfeded, the most serious outcome for thatcase. _ worker`�'�- - illness: No. Welder) injury (M) or Loading dock north end) and object/substance that directly injured or made onset of person ill(e.g.Second degree burns on right On job m illness forearm from acetylene torch) Deet, Days away Remained at work Away ansfer or � � _ o a _ (mo./day) from work From restrictionra Other record- r c° C ; 0 Job transfer work (days) o c ? c w c o or restriction able (days) Kacases i a (G) (H) (I) (J) (K) (L) (1) (2) (3) (4) (5) (6) Page totals o 0 0 0 0 0 0 0 0 0 0 0 Be sure to transfer these totals to the Summary page(Form 300A)before you post it. o a o m d c a O c = U includin time s a iD Public reporting burden for this collection of information is estimated to average 14 minutes per response, 9 = to review the instruction,search and gather the data needed,and complete and review the collection of information. Persons are not required to respond to the collection of information unless a displays a currently valid OMB control a number.If you have any comments about these estimates or any aspects of this data collection, S (6) (6) Department of Labor,OSHA Office of Statistics,Room N-3644,200 Constitution Ave,NW,Washington, Do Page 1 of 1 (1) (2) (3) (4) not send the completed forms to this office ri +`'": y,.L.0 r_ention: This form contains information relating to ``*�alth and must be used in a manner thatuj HA's Form 301 confidentiality of employees to the extent U.S.Department of Labor le the information is being used for Injuries and IIInesses Incident Report l safety and health purposes. Occupational Safety and Health Administration Form approved OMB no.1218-0176 Information about the employee Information about the case 10) Case number from the Log (Transfer the case number from the Log after you record the case.) 1) Full Name This Injury and Illness Incident Report is one of the 2) Street 11) Date of injury or illness first forms you must fill out when a recordable work- 12) Time employee began work AM/PM related injury or illness has occurred. Together with City State zip the Log of Work-Related injuries and Illnesses and 13) Time of event AM/PM ❑Check if time cannot be determined the accompanying Summary,these forms help the 3) Date of birth -Please do not include any personally rmaidentifiable infotion(PIO pertaining to worker(s)Involved in the incfdent(o.g,fro Dames,pbane employer and OSHA develop a picture of the extent nun,be ,orssN3)in thefeemving tiebs. and severity of work-related incidents. *14) What was the employee doing just before the incident occurred? Describe the activity,as well Within 7 calendar days after you receive 4) Date hired as the tools,equipment or material the employee was using. Be specific. Examples: "climbing a information that a recordable work-related injury or ladder while carrying roofing materials "spraying chlorine from hand sprayer";"daily computer key- illness has occurred,you must fill out this form or an 5)QMale entry." equivalent. Some state workers'compensation, []Female insurance,or other reports may be acceptable substitutes. To be considered an equivalent form, Information about the physician or other health care any substitute must contain all the information professional *15) What happened?Tell us how the injury occurred.Exampies:"When ladder slipped on wet floor, asked for on this form. worker fell 20 feet";"Worker was sprayed with chlorine when gasket broke during replacement"; According to Public Law 91-596 and 29 CFR 6) Name of physician or other health care professional "Worker developed soreness in wrist overtime." 1904,OSHA's recordkeeping rule,you must keep this form on file for 5 years following the year to which it pertains If you need additional copies of this form,you 7) If treatment was given away from the worksite,where was it given? may photocopy and use as many as you need. is) what was the Injury or illness?Tell us the part of the body that was affected and haw it was Facility affected. Examples:"strained back""chemical bum,hand";"carpal tunnel syndrome." Street City State Zip 8) Was employee treated in an emergency room? •17) What objector substance directly harmed the employee? Examples:"concrete floor", Complatted00, Yes "chlorine""radial arm saw."If this question does not apply to the incident,leave it blank. �No Title 9) Was employee hospitalized overnight as an in-patient? Phone e E]Yes 18) If the employee died,when did death occur? Date of death No viewing and ining e data ded,and completing and g the nforniation. Persons are Public reporting tsponddent for this collection ofInformation information is estimated displs a current verae 22 minutes OMB corer response,If luding you nave e for re meets about ihisnesh�rrtatst eor any ing (other aspectsf lhi sting-data sources,gd�atarcolglection,encu ding suggestiorns for reducing this burden.contact:US epartment ofof f Labor OSHA Office of � Statistics,Room N-3644,200 constitution Ave,NW,Washington,DC 20210. Do not send the completed fors to this office. r Note:You can type Input into this form and save it. Year 20 OSHA's Form 300A (Rev.04/2004) Because the forms in this recordkeeping package are"fellable/writable" 2- 0 1 PDF documents,you can type into the input form fields and U.S. Department of Labor Summary of Work-Related Injuries and Illnesses then save your inputs using the free Adobe PDF Reader. 0...p.tl.n.l s.f ty.ndn..leh Adrinnr,a.et.. Form approved OMB no.121"176 All establishments covered by Part 1904 must complete this Summary page,even if no work-related injuries or illnesses occurred during the year. Remember to review the Log to verify that the entries are complete and accurate before completing this summary. Using the Log,count the individual entries you made for each category. Then write the totals below,making sure you've added the entries from Establishment information every page of the Log.If you had no cases,write"0." Employees,former employees,and their representatives have the right to review the OSHA Form 300 in its entirety.They also have limited access rnar..rnnanm.nrnam. LONE STAR SITEWORK,LLC to the OSHA Form 301 or its equivalent.See 29 CFR Part 1904.35,in OSHA's recordkeeping rule,for further details on the access provisions for these forms. Street PO BOX 186 of City WIMBERLEY State TX zipi%%$ Tlirr Total number of Total number of Total number of cases Total number of Industry description(e.g.,Manufacture ofmotor truck trailers) deaths cases with days with job transfer or other recordable away from work restriction cases HIGHWAY, STREET&BRIDGE CONSTRUCTIOW 0 0 0 0 North American Industrial Classification(NAICS),if known(e.g.,336212) (G) (H) (1) (J)Number2 3 7 3 1 0 a Employment information(if you don't have these figures,see the Worksheet on the next page to estimate) Total number of days Total number of days of away from work job transfer or restriction Annual average number of employees 23 0 0 Total hours worked by all employees last year 58,700.00 (K) M Sign here Knowingly falsifying this document may result in a fine. Injury illness Types • I certify that I have examined this document and that to the best of Total number of... my knowledge the entries ate,accurate,and complete. (M) 0 (Y r CtC tf1A(Y�tn (1)Injuries 0 (4) Poisonings Company executive Title (2) Skin disorders 0 (5) Hearing loss 0 Phone 512-393-1582 Date 01/11/2022 (3) Respiratory conditions 0 (6) All other illnesses 0 Reset Post this Summary page from February 1 to April 30 of the year following the year covered by the form. Public reporting burden for this collection of information is estimated to average 58 minutes per response,including time to review the instructions,search and gather the data needed,and complete and review the collection of information.Persons are not required to respond to the collection of information unless it displays a currently valid OMB control number If you have any comments about these estimates or any other aspects of this data collection,contact-.US Department of Labor,OSHA office of Statistical Analysis.Room N-3644,200 Constitution Avenue,NW, Washington,DC 20210.Do not send the completed forms to this office. OSHA's Form 300 (Rev. 0412004) Note:You can type input into this form and save it. Attention:This form contains information relating to o f Wo rk-Related Because the forms in this recordkeeping package are"fillablelwritable" employee health and must be used in a manner that Year 20 21 Log PDF documents,you can type into the input form fields and protects the confidentiality of employees to the extent U.S. Department of Labor then save your inputs using the free Adobe PDF Reader.In addition, possible while the information is beingused for Injuries and Illnesses the forms are programmed to auto-calculate as appropriate occupational safety and health purposes. oeeapsuenat safety and Health Administration Form approved OMR no.1218-0176 Please Record: Reminders: •complete anInjury and Illness Incident Report(OSHA Form 301)orequivalent LONE STAR SITEWORK, LLL •Information about every work-related death and about every work-related injury orillness that involves loss of form for each injury or illness recorded on this form.Ifyou're not sure whether Establishment nm ae consciousness,restricted work activity orjob transfer,days away from work or medical treatment beyond first aid. case is recordable,call your local OSHA office for help. •Significant work-related injuries and illnesses that are diagnosed by a physician or licensed health care professional. .Feet free to use two lines fora single case if you need to. city W I MBE RLEY State TX •Work-related injuries and illnesses that meet any of the specific recording criteria listed in 29 CFR Port 1904.8 .Complete the 5 steps for each case. through 1904.12. - Step 3.Classify the case Step 1.Identify the person Step 2.Describe the case L SELECT ONLY ONE circle based on the (F) Enter the number o1 Select orre column: (A) (8) (C) (D) (E) days the Injured or 111 Case Employee's frame Job title Dateof injury Where the event occurred Describe injury or illness,parts of body worker was: no. leg,Welder) or onset of (e.g.,Loading Back north end) directly ended or add person that Remained at Work ❑mess illness directly injured or made person 81(e.g, .Second degree burns on right forearm from on job (M) re.g,21/0) ran5 a a acetylene torch Death Days away Job tafer other record- Away transfer or �- from work or .at,ictlon able cases from work restriction (G) (R) P) M (K) (u) N o a 0 0 0 0 _days _day. ()00000 Reset -111 day 0 0 0 0 _days —ears 000000 Reset month/day Reset 0 0 0 0 _days _dart: 000000 motto,!ear _- 0 0 0 0 _days _days 000000 Reset rtantn/say 0 0 0 0 _day, _days 000000 Reset month!say 0 0 0 0 _days _days 000000 Reset monm/say _ 0 0 0 0 _days _days 000000 Reset month!day 0 0 0 0 _sen _ears 000000 Reset monm/say Reset / 0 0 0 0 _date days 000000 monM!day Reset mpnth/day __ 0 0 0 0 _days _days 000000 Page totals � 0 0 0 0 O 0 0 0 0 Q 0 Public reporting burden for this collection of adorrstoon is estimated to average la rttireet c per respome•includingtime to mica the � -- imnucnons,wamh and gather the data needed,and complete and renew the collection of islomotion Pent are rot required to Add a Form Page 6 C respond to the.Vection of infomasion urd—a displays a--ittly veld OMB comml camber.If you bm arty conunerus about ares, Be sure to transfer these totals to the Summary page(Form 300A)be/ore you post it cuim ms or am'oacr aspects of this data collection contact.US Dopanncut of Labor,OSHA Office of Statistical Amlysis.Room N-36J4,2W Consurat,on Mew,NW,Washingtmi DC 10210.Do not se the c Wlcmd forms It,this()free. ol _ (t) (2) (3) (4) (5) (e) OSHA's Form 301 (Rev.04/2004) Note:You can type input into this form and save ft. Now orm contains information relating to t Because the forms m this recordkeeping package are"fillable/writable" healthand must be used in a manner that pp U.S.Department of Labor 1 n j u ry and Hines s PDF documents,you can type into the input form fields and rotects confidentialitye nfmt on is befneeused forexten Oeaup�tlonN as/ofy end Hesltn Adminlabatlan then save your inputs using the free Adobe PDF Reader.In addition, 9 Incident Report the forms are programmed to auto-calculate as appropriate. ety and health purposes. Form approved OMB m,1218-0176 Information about the employee Information about the case 'Ibis Injury and Illness Incident Report is one of the 10)Case number from the Uig (Transfer the case numberfram the log after you record the cose.) first forms you must fill out when a recordable q Fall name 11)Date of injury or illness work-related injury or illness has occurred.Together Month Day Yee with the Log of Work-Related Injuries and Illnesses 2)Street 12)Time employee begMM) work(HH Nuf) Q AM QPM and the accompanying Summary,these forms help State LIP ©AM QPM Q Check if time cannot be determined the employer and OSTIA develop a picture of the City 13J Time prevent asH extent and severity of( work-related incidents. 3)Date of birth Re fields 14 to 17:Please do not include any personalty identifiable information(Pill pertaining to worker(s)involved in the incident(e.g.,no names,phone numbers,a Social Security numbers). Within 7 calendar days after you receive information that a recordable work-related injury or Month Da} Year 14)*What was the employee doingjust before the incident occurred?Describe the activity,as well as the illness has occurred,you must fill out this form or an 4) Date hired tools,equipment,or material the employee was using.Be specific.Examples:"climbing a ladder while Month Day Year caning roofing materials";"spraying chlorine from hand sprayer";"daily computer key-entry. equivalent.Some state workers'compensation, insurance,or other reports may be acceptable s)Q Mate Q Female substitutes.To be considered an equivalent form,any Information about the physician or other health care substitute must contain all the information asked for professional15)•Whet Happened?Tell us how the injury occurred.Examples:"When ladder slipped on wet floor,worker fell On this form. Name of physician or other health care professional 20 feet';"Worker was sprayed with chlorine when gasket broke during replacement";"Worker developed According to Public Law 91-596 and 29 CFR soreness in wrist over time 1904,OSHA's recordkeeping rule,you must keep this form on file for 5 years following the year to which it pertains. '>) If treatment was given away from the worksite,where was it given If you need additional copies of this form,you may photocopy the printout or insert additional form Facility 16)*What was the Injury or illness?E---- -us the part of the body that was affected and how it was affected. pages in the PDF,and then use as many as you need. Examples:"stra ned back";"chemical burn,hand";"carpal tunnel syndrome." Street City State LIP 17)-What object or substance directly harmed the employee?Examples:"concrete floor";"chlorine", "radial arm saw."If this question does not apply to die incident,leave it blank. 8)Was employee treated in an emergency room? Completedby CULLEN HARRISON Q Yes Q No Title MANAGING MEMBER If tha employee died,when did death occur?F - Date of death 9)Was employee hospitalized overnight as an in-patient? 18) Month Day Year 512-393-1582 Date 01-11-2022 Q Yes Phone Q Reset Month Day Year No Add a Form Page time to' og it b B B theo and ouna,a bnr,OSHA Office of Statistical cor(dfrogAnaand Rimsourn g the �2W ConstitutionAtrenueeNW.WmWai ontDCt20210 notnot send the omplc rd fame to fills tdice.�l•sa macul curtel ot�OMB controlrutnber.If you have ram.—..Is about his a titmle or am other acts of thisdamcol collection.including stp,Bet ons for ted cin xtlus burden otttut�US IXp:t City of Round Rock,Texas Contract Forms Standard Form of Agreement: Section 00500 City of Round Rock, Texas Standard Form of Agreement between Owner and Contractor AGREEMENT made as of the ( )day of in the year 2024 BETWEEN the Owner: City of Round Rock,Texas(hereafter"Owner"or"City") 221 East Main Street Round Rock,Texas 78664 and the Contractor Lone Star Site Work,LLC ("Contractor") P.O.Box 1867 Wimberley TX,78676 The Project is described as: Chisholm Tr.Rd.&W.Old Settlers Blvd. Kight I urn Lane Improvements The Engineer is: Steven D,Widacki P.E. American Structurepoint,Inc. 3711 South Mopac Expressway Building One Suite 350.Austin Texas,78746 For and in consideration of the mutual terms, conditions and covenants of this Agreement and all accompanying documents between Owner and Contractor, the receipt and sufficiency of which are hereby acknowledged,Owner and Contractor agree as follows: ARTICLE I THE CONTRACT DOCUMENTS The Contract Documents consist of this Agreement,Conditions of the Contract(General,Supplementary and other Conditions),Drawings, Specifications,Addenda issued prior to execution of this Agreement,other documents listed in this Agreement and Modifications issued after execution of this Agreement;these form the Contract,and are as fully a part of the Contract as if attached to this Agreement or repeated herein.The Contract represents the entire and integrated agreement between the parties hereto and supersedes prior negotiations,representations or agreements, either written or oral.An enumeration of the Contract Documents,other than Modifications,appears in Article 7. ARTICLE 2 THE WORK OF THIS CONTRACT Contractor shall fully execute the Work described in the Contract Documents,except to the extent specifically indicated in the Contract Documents to be the responsibility of others. 00500 4-2020 Page 1 of 5 Standard Form of Agreement 00443647 ARTICLE 3 DATE OF COMMENCEMENT;DATE OF SUBSTANTIAL COMPLETION;DATE OF FINAL COMPLETION 3.1 The date of commencement of the Work shall be the date of this Agreement unless a different date is stated below or provision is made for the date to be fixed in a Notice to Proceed issued by Owner. 3.2 The Contract Time shall be measured from the date delineated in the Notice to Proceed. 3.3 Contractor shall commence Work within ten 110 ) calendar days from the date delineated in the Notice to Proceed. 3.4 Contractor shall achieve Substantial Completion of the items of Work listed on Attachment A to this Agreement no later than one hundred twenty 120 and Contractor shall achieve Substantial Completion of the entire Work no later than one hundred twenty 120 )calendar days from issuance by Owner of Notice to Proceed,subject to adjustments of this Contract Time as provided in the Contract Documents. 3.5 If Contractor fails to achieve Substantial Completion of the Work(or any portion thereof)on or before the date(s)specified for Substantial Completion in the Agreement,Contractor shall pay to Owner,as liquidated damages, the sum of five hundred and No/100 Dollars($500 ) for each calendar day that Substantial Completion is delayed after the date(s) specified for Substantial Completion. It is hereby agreed that the liquidated damages to which Owner is entitled hereunder are a reasonable forecast of just compensation for the harm that would be caused by Contractor's failure to achieve Substantial Completion of the Work(or any portion thereof)on or before the date(s)specified for Substantial Completion in the Agreement and is not a penalty. It is agreed that the harm that would be caused by such failure, which includes loss of expected use of the Project areas,provision of alternative storage facilities and rescheduling of moving and occupancy dates,is one that is incapable or very difficult of accurate estimation.It is hereby agreed that if Substantial Completion of the Work(or any portion thereof)is not achieved on or before thirty(30)days after the date(s) specified for Substantial Completion in the Agreement, the Owner shall have the option to either collect liquidated damages as set forth herein or to thereafter rely on its remedies under the Contract Documents and at law and in equity, including without limitation, the recovery of actual damages. The date(s) specified for Substantial Completion of the Work(or any portion thereof)in the Agreement shall be subject to adjustment as provided in the Contract Documents. 3.6 Contractor shall achieve Final Completion of the entire Work no later than one hundred twenty 1( 20 )calendar days from issuance by Owner of Notice to Proceed. ARTICLE 4 CONTRACT SUM 4.1 Owner shall pay Contractor the Contract Sum in current funds for Contractor's full and complete performance of the Work and all of Contractor's obligations under this Agreement. The Contract Sum shall be Six hundred twenty-eight thousand three hundred nine dollars&ninety cents ($628,309.90 ),subject to additions and deductions as provided in the Contract Documents, 4.2 Does the Contract Sum include alternates which are described in the Bid Form? No X . Yes .IJyes,please provide details below: 00500 42020 Page 2 of 5 Standard Form of Agreement 00443647 ARTICLE 5 PAYMENTS 5.1 PROGRESS PAYMENTS 5.1.1 Based upon Applications for Payment submitted to Engineer and Owner by Contractor,and Certificates for Payment issued by Engineer and not disputed by Owner and/or Owner's lender,Owner shall make progress payments on account of the Contract Sum to Contractor as provided below, in Article 14 of the General Conditions, and elsewhere in the Contract Documents. 5.1.2 The period covered by each Application for Payment shall be one calendar month ending on the last day of the month. 5.1.3 Provided that an Application for Payment is received by Engineer and Owner, and Engineer issues a Certificate of Payment not later than the tenth (10th)day of a month, Owner shall make payment to Contractor of amounts approved by the Owner not later than the tenth(10th)day of the next month.If an Application for Payment is received by Engineer and Owner after the application date fixed above,payment shall be made by Owner not later than one month after the Engineer issues a Certificate for Payment.The Owner shall not have any obligation to pay any amount covered by the Engineer's Certificate for Payment that is disputed by the Owner. 5.1.4 Each Application for Payment shall be based on the most recent schedule of values submitted by Contractor in accordance with the Contract Documents.The schedule of values shall allocate the entire Contract Sum among the various portions of the Work.The schedule of values shall be prepared in such form and supported by such data to substantiate its accuracy as Engineer and Owner may require.This schedule,unless objected to by Engineer or Owner, shall be used as a basis for reviewing Contractor's Applications for Payment. 5.1.5 Applications for Payment shall warrant the percentage of completion of each portion of the Work as of the end of the period covered by the Application for Payment. 5.1.6 Subject to other provisions of the Contract Documents, the amount of each progress payment shall be computed as provided in Article 14 of the General Conditions. 5.1.7 Except with Owner's prior written approval, Contractor shall not make advance payments to suppliers for materials or equipment which have not been delivered and stored at the site. 5.2 FINAL PAYMENT 5.2.1 Final payment, constituting the entire unpaid balance of the Contract Sum, shall be made by Owner to Contractor when: .1 Contractor has fully performed the Contract except for Contractor's responsibility to correct Work, and to satisfy other requirements,if any,which extend beyond final payment;and .2 a final Certificate for Payment has been issued by Engineer and approved by the Owner. 5.2.2 Owner's final payment to Contractor shall be made no later than thirty (30) days after the issuance of Engineer's final Certificate for Payment. In no event shall final payment be required to be made prior to thirty(30) days after all Work on the Contract has been fully performed.Defects in the Work discovered prior to final payment shall be treated as non-conforming Work and shall be corrected by Contractor prior to final payment,and shall not be treated as warranty items. ARTICLE 6 TERMINATION OR SUSPENSION 6.1 The Contract may be terminated by Owner or Contractor as provided in Article 15 of the General Conditions. 00500 4-2020 Page 3 of 5 Standard Form of Agreement 00443647 6.2 The Work may be suspended by Owner as provided in Article 15 of the General Conditions. ARTICLE 7 ENUMERATION OF CONTRACT DOCUMENTS 7.1 The Contract Documents,except for Modifications issued after execution of this Agreement,are enumerated as follows: 7.1.1 The Agreement is this executed version of the City of Round Rock, Texas Standard Form of Agreement between Owner and Contractor,as modified. 7.1.2 The General Conditions are the "City of Round Rock Contract Forms 00700," General Conditions, as modified. 7.1.3 The Supplementary,Special,and other Conditions of the Contract are those contained in the Project Manual dated January 2024 7.1.4 The Specifications are those contained in the Project Manual dated January 2024 7.1.5 The Drawings,if any,are those contained in the Project Manual dated January 2024 7.1.6 The Insurance&Construction Bond Forms of the Contract are those contained in the Project Manual dated January 2024 7.1.7 The Notice to Bidders,Instructions to Bidders,Bid Form,and Addenda,if any,are those contained in the Project Manual dated January 2024 7.1.8 If this Agreement covers construction involving federal funds, thereby requiring inclusion of mandated contract clauses, such federally required clauses are those contained in the "City of Round Rock Contract Forms 03000,"Federally Required Contract Clauses,as modified. 7.1.9 Other documents,if any,forming part of the Contract Documents are as follows: AA ARTICLE 8 MISCELLANEOUS PROVISIONS 8.1 Where reference is made in this Agreement to a provision of any document, the reference refers to that provision as amended or supplemented by other provisions of the Contract Documents. 8.2 Owner's representative is: Gree Ciaccio City of Round Rock 512.218.7017 gciaccio&mundrocktexas.gov 8.3 Contractor's representative is: Megan Harrison Lone Star Sitework.LLC 512-994-7811 megan(d)lonestarsitework.com 8.4 Neither Owner's nor Contractor's representative shall be changed without ten(10)days'written notice to the other party. 00500 4-2020 Page 4 of 5 Standard Form of Agreement 00443647 8.5 Waiver of any breach of this Agreement shall not constitute waiver of any subsequent breach. 8.6 Owner agrees to pay Contractor from available funds for satisfactory performance of this Agreement in accordance with the bid or proposal submitted therefor,subject to proper additions and deductions,all as provided in the General Conditions, Supplemental Conditions, and Special Conditions of this Agreement, and Owner agrees to make payments on account thereof as provided therein. Lack of funds shall render this Agreement null and void to the extent funds are not available. This Agreement is a commitment of City of Round Rock's current revenues only. 8.7 Although this Agreement is drawn by Owner,both parties hereto expressly agree and assert that,in the event of any dispute over its meaning or application,this Agreement shall be interpreted reasonably and fairly,and neither more strongly for nor against either party. 8.8 This Agreement shall be enforceable in Round Rock,Texas,and if legal action is necessary by either party with respect to the enforcement of any or all of the terms or conditions herein,exclusive venue for same shall lie in Williamson County, Texas. This Agreement shall be governed by and construed in accordance with the laws and court decisions of the State of Texas. 8.9 Both parties hereby expressly agree that no claims or disputes between the parties arising out of or relating to this Agreement or a breach thereof shall be decided by an arbitration proceeding,including without limitation,any proceeding under the Federal Arbitration Act(9 USC Section 1-14)or any applicable state arbitration statute. 8.10 The parties, by execution of this Agreement, bind themselves, their heirs, successors, assigns, and legal representatives for the full and faithful performance of the terms and provisions hereof. This Agreement is entered into as of the day and year first written above and is executed in at least two(2) original copies,of which one is to be delivered to Owner. OWNER CONTRACTOR CITYJF ROU R K,TEXAS LONE STAR SITEWORK,LLC Cullen Harrison Printed ame: Printed Name: Title IrV lQ of Title: Managing Member Date Signed:) / 2 Date Signed: 03/21/2024 ATTES City Clerk FOR CI ,APPROVED AS TO FORM: City A orney 00500 4-2020 Page 5 of 5 Standard Form of Agreement 00443647 Bond No. 100364277 PERFORMANCE BOND THE STATE OF TEXAS § § KNOW ALL BY THESE PRESENTS: COUNTY OF WILLIAMSON § That Lone Star Sitework, LLC , of the City of Wimberley , County of Hays , and State of Texas , as Principal,and Merchants Bonding Company(Mutual) authorized under the law of the State of Texas to act as surety on bonds for principals, are held and firmly bound unto the CITY OF ROUND ROCK,TEXAS (Owner), in the penal sum of Six hundred twenty-eight thousand three hundred nine dollars&ninety cents Dollars ($628,309.90 ) for the payment whereof, well and truly to be made the said Principal and Surety bind themselves, and their heirs, administrators, executors, successors and assigns,jointly and severally,by these presents: WHEREAS, the Principal has entered into a certain written Agreement with the Owner dated the !ay day of ,20to which the Agreement is hereby referred to and made a part hereof as fully and tote same elent as if copied at length herein consisting of: Chisholm Tr. Rd. &W. Old Settlers Blvd. Right Turn Lane Improvements NOW, THEREFORE, THE CONDITIONS OF THIS OBLIGATION IS SUCH, that if the said Principal shall faithfully perform said Agreement and shall, in all respects, duly and faithfully observe and perform all and singular the covenants, conditions and agreements in and by said Agreement, agreed and covenanted by the Principal to be observed and performed, including but not limited to, the repair of any and all defects in said work occasioned by and resulting from defects in materials furnished by or workmanship of,the Principal in performing the Work covered by said Agreement and occurring within a period of twenty four (24) months from the date of Final Completion and all other covenants and conditions, according to the true intent and meaning of said Agreement and the Plans and Specifications hereto annexed,then this obligation shall be void;otherwise to remain in full force and effect; PROVIDED, HOWEVER,that this bond is executed pursuant to the provisions of Chapter 2253, Texas Government Code, as amended, and all liabilities on this bond shall be determined in accordance with the provisions of said Chapter 2253 to the same extent as if it were copied at length herein. Page 1 00610 4-2020 Performance Bond 00443639 PERFORMANCE BOND (continued) Surety, for value received, stipulates and agrees that no change, extension of time, alteration or addition to the terms of the Agreement, or to the Work performed thereunder, or the Plans, Specifications, or drawings accompanying the same, shall in anywise affect its obligation on this bond,and it does hereby waive notice of any such change,extension of time,alteration or addition to the terms of the Agreement, or to the work to be performed thereunder. If Principal fails to faithfully perform said Agreement, Surety, after receipt of written notice of Principal's default,shall perform all of Principal's duties and obligations under the Agreement. If, within ten (10) days after receipt of such notice from Owner, Surety does not commence to complete the obligations of Principal with a contractor acceptable to Owner and diligently complete the performance of the Principal's duties and obligations, Owner shall have the right but not the obligation to have the duties and obligations of Principal performed. In such event, Surety shall pay to Owner,upon demand,all costs, expenses and damages sustained by Owner as a result of Principal's failure to perform its duties and obligations under the Agreement up to the $628,309.90 sum of this Performance Bond, plus all costs and expenses, including attorney's fees and expert and consultant fees incurred by Owner to enforce its rights under this Performance Bond. IN WITNESS WHEREOF, the said Principal and Surety have signed and sealed this instrument this 25*- day of KOLYC.h , 20 Zq. Lone Star Sitework, LLC Merchants Bonding Company(Mutual) P ' cipal Surety Cynthia A Alford Printed Name Printed Name By: By: - Title: l�0�n0.Llit�a� rvrnYlo,✓ Title: Att ney-in-Fact Address:P.O. Box 1867 Address: P.O. Box 14498 Wimberley, TX 78676 Des Moines, IA 50306-3498 Resident Agent of Signature Russ Frenzel Printed Name 500 N Central Expy Suite 550 Street Address Plano, TX 75074 City, State&Zip Code Page 2 00610 4-2020 Performance Bond 00443639 Bond No. 100364277 PAYMENT BOND THE STATE OF TEXAS § § KNOW ALL MEN BY THESE PRESENTS: COUNTY OF WILLIAMSON § That Lone Star Sitework,LLC , of the City of Wimberley County of Hays , and State of Texas , as Principal, and Merchants Bonding Company(Mutual) authorized under the laws of the State of Texas to act as Surety on Bonds for Principals,are held and firmly bound unto the CITY OF ROUND ROCK, TEXAS (OWNER), and all subcontractors, workers, laborers, mechanics and suppliers as their interest may appear, all of whom shall have the right to sue upon this bond, in the penal sum of Six hundred twenty-eight thousand three hundred nine dollars&ninety cents Dollars($ 628,309.90 )for the payment whereof,well and truly be made the said Principal and Surety bind themselves and their heirs, administrators, executors, successors, and assigns,jointly and severally, by these presents: WHEREAS,the Principal has entered into a certain written Agreement with the Owner,dated the day of , 2QZ to which Agreement is hereby referred to and made a part hereof as fully and 4 the same extent as if copied at length herein consisting of: Chisholm Tr. Rd. &W. Old Settlers Blvd. Right I urn Lane Improvements NOW, THEREFORE, THE CONDITION OF THIS OBLIGATION IS SUCH, that if the said Principal shall well and truly pay all subcontractors, workers, laborers, mechanics, and suppliers, all monies to them owing by said Principals for subcontracts,work,labor,equipment,supplies and materials done and furnished for the construction of the improvements of said Agreement, then this obligation shall be and become null and void; otherwise to remain in full force and effect. PROVIDED, HOWEVER, that this bond is executed pursuant to the provisions of Chapter 2253, Texas Government Code, as amended, and all liabilities on this bond shall be determined in accordance with the provisions of said Chapter 2253 to the same extent as if it were copied at length herein. Page 1 00620 04-2020 Payment Bond 00437699 PAYMENT BOND (continued) Surety, for value received, stipulates and agrees that no change, extension of time, alteration or addition to the terms of the Agreement, or to the Work performed thereunder, or the plans, specifications or drawings accompanying the same shall in anywise affect its obligation on this bond,and it does hereby waive notice of any such change,extension of time,alteration or addition to the terms of the contract, or to the work to be performed thereunder. IN WITNESS WHEREOF, the said Principal and Surety have signed and sealed this Instrument this 25+�% day of tAGi,Y0A , 20_�J. Lone Star Sitework LLC Merchants Bonding Company(Mutual) Principal Surety CAA tin parr i-50y\ Cynthia A Alford Printed Name Printed Name By: h By: - Title: Title: At mey-in-Fact Address: P.O. Bo c 18 Address: P.O. Box 14498 Wimberley, TX 78676 Des Moines, IA 50306-3498 Resident Agent of S ety- Signature Russ Frenzel Printed Name 500 N. Central Expy., Suite 5.50 Street Address Plano,TX 75074 City, State&Zip Code Page 2 00620 1-2020 Payment Bond 00090656 MERCHANT BONDING COMPANY. POWER OF ATTORNEY Know All Persons By These Presents,that MERCHANTS BONDING COMPANY(MUTUAL)and MERCHANTS NATIONAL BONDING, INC., both being corporations of the State of Iowa,d/b/a Merchants National Indemnity Company(in California only)(herein collectively called the "Companies")do hereby make,constitute and appoint,individually, Blaine Allen;Brady K Cox;Brent Baldwin;Brock Baldwin;Chandler Nazzal;Cynthia A Alford;John A Aboumrad;Keith Rogers;Kristen Ortiz;Lorena Gutierrez;Michael B Hill;Neira Hernandez;Russ Frenzel;Samuel Freireich;Sylvia Thomas;Veronica Ramos;William D Baldwin;Yamillec Ramos their true and lawful Attorney(s)-in-Fact, to sign its name as surety(ies) and to execute, seal and acknowledge any and all bonds, undertakings, contracts and other written instruments in the nature thereof, on behalf of the Companies in their business of guaranteeing the fidelity of persons, guaranteeing the performance of contracts and executing or guaranteeing bonds and undertakings required or permitted in any actions or proceedings allowed by law. This Power-of-Attorney is granted and is signed and sealed by facsimile under and by authority of the following By-Laws adopted by the Board of Directors of Merchants Bonding Company (Mutual)on April 23, 2011 and amended August 14, 2015 and adopted by the Board of Directors of Merchants National Bonding,Inc.,on October 16,2015. "The President, Secretary, Treasurer, or any Assistant Treasurer or any Assistant Secretary or any Vice President shall have power and authority to appoint Attomeys-in-Fact, and to authorize them to execute on behalf of the Company, and attach the seal of the Company thereto, bonds and undertakings,recognizances,contracts of indemnity and other writings obligatory in the nature thereof." "The signature of any authorized officer and the seal of the Company may be affixed by facsimile or electronic transmission to any Power of Attorney or Certification thereof authorizing the execution and delivery of any bond, undertaking, recognizance, or other suretyship obligations of the Company,and such signature and seal when so used shall have the same force and effect as though manually fixed." In connection with obligations in favor of the Florida Department of Transportation only, it is agreed that the power and aut hority hereby given to the Attorney-in-Fact includes any and all consents for the release of retained percentages and/or final estimates on engineering and construction contracts required by the State of Florida Department of Transportation. It is fully understood that consenting to the State of Florida Department of Transportation making payment of the final estimate to the Contractor and/or its assignee, shall not relieve this surety company of any of its obligations under its bond. In connection with obligations in favor of the Kentucky Department of Highways only,it is agreed that the power and authority hereby given to the Attorney-in-Fact cannot be modified or revoked unless prior written personal notice of such intent has been given to the Commissioner- Department of Highways of the Commonwealth of Kentucky at least thirty(30)days prior to the modification or revocation. In Witness Whereof,the Companies have caused this instrument to be signed and sealed this 23rd day of January 2023 ••'•"""•• •• •• MERCHANTS BONDING COMPANY(MUTUAL) ••••�P110Ngt •��N�'.Cai)j••. MERCHANTS NATIONAL BONDING,INC. �y pt�POR4 &O: �O�pAPOgq'O9Z d/b/a MERCHANTS NATIONAL INDEMNITY COMPANY °v 2003 :4): 1933 c: By ":�� ., ;�� '.•d�j ... `1'a•: President STATE OF IOWA '•.� ,••' •••.• �.•'• COUNTY OF DALLAS ss. On this 23rd day of January 2023 before me appeared Larry Taylor, to me personally known, who being by me duly sworn did say that he is President of MERCHANTS BONDING COMPANY (MUTUAL)and MERCHANTS NATIONAL BONDING, INC.; and that the seals affixed to the foregoing instrument are the Corporate Seals of the Companies;and that the said instrument was signed and sealed in behalf of the Companies by authority of their respective Boards of Directors. ICnn Lee z . Comr Cma Number 70n o m,a A011 2024 Notary Public (Expiration of notary's commission does not invalidate this instrument) I,William Warner,Jr.,Secretary of MERCHANTS BONDING COMPANY(MUTUAL)and MERCHANTS NATIONAL BONDING,INC.,do hereby certify that the above and foregoing is a true and correct copy of the POWER-OF-ATTORNEY executed by said Companies,which is still in full force and effect and has not been amended or revoked. ��++ 1_ `r In Witness Whereof, I have hereunto set my hand and affixed the seal of the Companies on this ?#Aday of �. PA • :Z ?�p %�O'. . ,z,e:�� w,o-.,,�. a. -0- 2003 :`7 :s _ 1933 :c• Secretary 4. POA 0018 (10/22) "'• MERCHANTS BONDING COMPANY,. MERCHANTS BONDING COMPANY(MUTUAL) - MERCHANTS NATIONAL BONDING, INC. 2100 FLEUR DRIVE , DES MOINES, IOWA 50321-1158 • (800)678-8171 • (515)243-3854 FAX IMPORTANT NOTICE To obtain information or make a complaint: You may contact your insurance agent at the telephone number provided by your insurance agent. You may call Merchants Bonding Company (Mutual) toll-free telephone number for information or to make a complaint at: 1-800-678-8171 You may contact the Texas Department of Insurance to obtain information on companies, coverages, rights or complaints at: 1-800-252-3439 You may write the Texas Department of Insurance at: P. O. Box 149104 Austin, TX 78714-9104 Fax: (512)475-1771 Web: http://www.tdi.state.tx.us E-mail: ConsumerProtection@tdi.texas.gov PREMIUM AND CLAIM DISPUTES: Should you have a dispute concerning your premium or about a claim you should contact the agent first. If the dispute is not resolved, you may contact the Texas Department of Insurance. ATTACH THIS NOTICE TO YOUR POLICY: This notice is for information only and does not become a part or condition of the attached document. SUP 0032 TX(12/13) ACORO® CERTIFICATE OF LIABILITY INSURANCE FD032112024 V) 03%21/2024 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder Is an ADDITIONAL INSURED,the policy(ies)must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTE.ACT Angie Dahl _ D&D Insurance Agency PHONE FAX PO Box 2249 (a r NnTF»1. (512)847 5549 (ysy Ne,:(512)847-2107 E-MAILinfo@dd-ins.net Wimberley TX 78676- GoRr INSURERISI AFFORDING COVERAGE INSURER A,Travelers Prop Cas Co 25674 INSURED INSURER B:Travelers Indemnity Co 25674 Lone Star Sitework,LLC INSURERC:GuineOne National Ins 14167 PO Box 1867 _INSURER D:Texas Mutual Ins Co 22945 Wimberley TX 78676- INSURER E: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR TYPE OF INSURANCE ADDL SUER POLICY NUMBER POLICY EFF POLICY EXP LIMITS B X COMMERCIAL GENERAL LIABILITY X X DTCO8WO44578 7/20/2023 7/20/2024 EACH OCCURRENCE S 1+000+000 CLAIMS-MADE F OCCUR DAMAGE TO RENTED 300,000 MED EXP(Any oneperson) 5+000 PERSONAL&ADV INJURY 1,000,000 M'OTHER' L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE 2+000+000 POLICYT JECOT- LOC PRODUCTS-COMP/OP AGG2+000+000 $ A AUTOMOBILE LIABILITY X X BA 8W047359-23 7/20/2023 07/20/2024 COMBINED SINGLE LIMIT $ 1,000,000 X ANY AUTO BODILY INJURY(Per person) $ OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS ONLY AUTOS HIRED NON-OWNED PROPERTY DAMAGE $ AUTOS ONLY AUTOS ONLY (Par 2nddano A X UMBRELLA UABX OCCUR X CUP 8W048645-23 7/20/2023 7/20/2024 EACH OCCURRENCE_ 5,000,000 EXCESS Like CLAIMS-MADE AGGREGATE 5+000+000 DED I RETENTION D WORKERS COMPENSATION X 0002006377 12/04/2023 12/04/2024 X I PER oTH- AND EMPLOYERS'LIABILITY 1+000,000 ANY PROPRIETOR/PARTNEWEXECUTWE ❑ E.L.EACH ACCIDENT OFFICERIMEMBEREXCLUDED? N/A 1000000 (Mandatory In NH) E.L.DISEASE-EA EMPLOYEE + + If yes,describe under 1000000 DISEASE-P LIMIT , , B Equipment DTCO 8WO44578 7/20/2023 7/20/2024 Rented/Leased Equip $250,000 C ENV562011546-01 8/27/2023 8/27/2024 Per Occurrence $1,000,000 Pollution Lia Aggregate Limit $2,000,000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(ACORD 101,Additional Remarks Schedule may be attached If more space is required) The General Liability Policy affords Automatic Additional Insured status on a blanket basis when required by written contract including Completed Operations with Policy Forms CG D6 04 02 19. General Liability includes a Blanket Waiver of Subrogation when required by written contract for Form CG D3 16 02 19. General Liability is Primary with Form CGT100,Sec IV.Business Auto is Primary and Noncontributory with Form CA T4 99 02 16,Blanket Additional Insured with a Waiver of Subrogationi as required by written contract with Form CA T3 53 02 15.Workers Compensation provides a Waiver of Subrogation on a blanket basis with Form WC 42 03 04 B. Umbrella is form following 30 Day Cancellation Notice applies CERTIFICATE HOLDER CANCELLATION A1008134 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN City of Round Rock ACCORDANCE WITH THE POLICY PROVISIONS. 221 E Main St Round Rock TX 78664- AUTHORIZED REPRESENTATIVE Q 1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD